Individual Healthcare Provider
Judith Ann Black, PHD, LPC, LCMHC, NCC
Provider's NPPES record last updated: March 16, 2023
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1003110198
- Primary Specialty
- Counselor — Professional
- Practice Location
- Fairmont, West Virginia
- Sole Proprietor
- Yes
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 18, 2026, 4:22 AM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Counselor
Professional
Behavioral Health & Social Service Providers
Definition to come...
Taxonomy code 101YP2500X
Provider-Reported License Information
- Counselor (West Virginia)
- 2278
- Counselor (North Carolina)
- A8388
- Counselor (Virginia)
- 0701005401
- Counselor (North Carolina)
- 275728
- Counselor (North Carolina)
- 8388
Practice Locations
Practice Location
207 Fairmont Ave
Fairmont, West Virginia 26554-2710
Phone: (681) 404-6869
Additional Practice Location
12 Woodcliff Dr
Fairmont, West Virginia 26554-1257
Phone: (910) 689-7100
Additional Practice Location
3135 16th Street Rd
Huntington, West Virginia 25701-5247
Phone: (681) 404-6869
Fax: (681) 404-6871
Record Information
- Enumeration Date
- January 4, 2011
- Provider's NPPES Record Last Updated
- March 16, 2023
- Certification Date
- March 16, 2023
- NPISignal NPPES Dataset
- August 2026
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