MS. PHYLLIS BLACK (NPI# 1972652303) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972652303 |
| Entity Type | Individual |
| Full Name | MS. PHYLLIS BLACK |
| Credential | MSW LCSW ACSW |
| Practice Address |
1500 Kings Highway North Suite C 208 Cherry Hill NJ 08034 |
| Mailing Address |
101 Mansfield Blvd South Cherry Hill NJ 08034 |
| Practice Telephone | 8564276703 |
| Practice Fax Number | 8564276703 |
| Mailing Telephone | 8564281247 |
| Mailing Fax Number | 8564276703 |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2012-09-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 104100000X | Social Worker | SW006984L | PA | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
44SC00195000 | NJ | Behavioral Health & Social Service Providers |
| N | 106H00000X | Marriage & Family Therapist | 37F100134400 | NJ | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | HORIZON AMERHEALTH PC | 0472339000 | 01 |
| NJ | MAGELLAN | 229945000 | 01 |
| NJ | AETNA | 4452670 | 01 |
| NJ | BLUE CROSS BLUE SHIELD IB | 0472339000 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407186869 | Phyllis Regina Black | Counselor | 325 9th Ave # 359797, Seattle, WA 98104-2420 | 2010-01-07 |
| 1295950392 | Phyllis Black | Nurse's Aide | 2925 Navajo Ave, Fort Pierce, FL 34946-6740 | 2007-04-16 |
| Street Address |
1500 KINGS HIGHWAY NORTH SUITE C 208 |
| City | CHERRY HILL |
| State | NJ |
| Zip Code | 08034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821606054 | Glickman Psychological Services, LLC | Psychologist | 80 Barclay Center, Suite 4, Cherry Hill, NJ 08034 | 2020-07-14 |
| 1215455225 | Arc of Camden County Millhurst Supported Living | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 141 Hayes Mill Road, Apt 218, Cherry Hill, NJ 08034 | 2017-08-30 |
| 1144748120 | Arc of Camden County Chanticleer Drive Supported Living | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 712 Chanticleer Drive, Cherry Hill, NJ 08034 | 2017-08-30 |
| 1124558689 | 1 Choice Home Health Care, LLC | Home Health | 1409 E. Highway 70, Barclay Pavilion, Suite 207w, Cherry Hill, NJ 08034 | 2017-06-18 |
| 1205362621 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 405 Wayland Rd, Cherry Hill, NJ 08034 | 2017-05-04 |
| 1598291940 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 19 Brookdale Dr, Cherry Hill, NJ 08034 | 2017-05-04 |
| 1861928285 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 302 Portsmouth Rd, Cherry Hill, NJ 08034 | 2017-05-04 |
| 1265967954 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8 Farmhouse Ln, Maple Shade, NJ 08034 | 2017-05-01 |
| 1023543709 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 407 Cranford Rd, Cherry Hill, NJ 08034 | 2017-05-01 |
| 1588199269 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 21 Colgate Drive, Cherry Hill, NJ 08034 | 2017-05-01 |
| Find all providers in zip 08034 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700490042 | Falcon Counseling Services | Social Worker | 1040 Kings Hwy N Ste 404, Cherry Hill, NJ 08034-1920 | 2020-09-03 |
| 1194282558 | David Michael Martino Jr. | Social Worker | 1930 Marlton Pike E Bldg 7, Cherry Hill, NJ 08003-2150 | 2019-02-21 |
| 1124596648 | Michael Aitcheson | Social Worker | 206 S Brookfield Rd, Cherry Hill, NJ 08034-3745 | 2018-11-02 |
| 1437637626 | Rachel Johnson | Social Worker | 1030 Kings Hwy N Ste 202, Cherry Hill, NJ 08034-1907 | 2018-07-31 |
| 1780160507 | Kim Harrison Zaun | Social Worker | 1016 Salem Rd, Cherry Hill, NJ 08034-3656 | 2018-07-15 |
| 1356831044 | Mirel Adler | Social Worker | 327 Cherry Hill Blvd, Cherry Hill, NJ 08002-1908 | 2018-05-17 |
| 1689182974 | Guided Paths LLC | Social Worker | 727 Cobble Creek Cir, Cherry Hill, NJ 08003-1843 | 2018-01-20 |
| 1003327958 | Spring Behavioral Health of New Jersey | Social Worker | 409 Route 70 E Ste 2, Cherry Hill, NJ 08034-2413 | 2017-10-18 |
| 1477064608 | Morra Molotsky | Social Worker | 1218 Chanticleer, Cherry Hill, NJ 08003-4815 | 2017-10-16 |
| 1962946178 | Rod J. Herrera, Lcsw, LLC | Social Worker | 36 Kresson Rd Ste D, Cherry Hill, NJ 08034-3227 | 2016-12-06 |
| Find all providers in CHERRY HILL | ||||
| City | CHERRY HILL |
| Zip Code | 08034 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.