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General NPI Number Information
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NPI Number | 1669024246
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Entity Type | Individual
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Provider Name | JOSHUA JAY BLACK APRN, PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 07/12/2019
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 10123 ALLIANCE RD STE 240
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City | BLUE ASH
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State | OH
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Zip | 45242-4887
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Country | US
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Telephone | 513-530-1600
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Fax |
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Provider Business Mailing Address
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Address Line | 13154 NAVARRE RD SW
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City | BEACH CITY
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State | OH
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Zip | 44608-9749
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Country | US
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Telephone | 330-417-9497
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | SP023693
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN.CNP.025127
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License Number State | OH
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