KATHERINE L BLACK (LCSW) – Clinical Social Worker, NPI 1700342540

KATHERINE L BLACK (LCSW) is a healthcare provider. based in Orange park, Florida. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. SW15161 (FL). The NPI Number for KATHERINE L BLACK (LCSW) is 1700342540

Main info

Female
Sole Proprietor
12 Years Of Experience
Accepts Medicare Assignment
Name
KATHERINE L BLACK (LCSW)
NPI
1700342540
Phone
(904) 264-6977
Address
1543 KINGSLEY AVE STE 14
Enumeration Date
18 February 2019
Last Update Date
18 February 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9042646977
Graduation Year
2014 (12 years ago)
PAC ID
5395084925
Group Practice PAC ID
9133441421
Professional Enrollment ID
I20190226002975
Address ID
FL320734570OR1543XAVEX301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:7State licenses:1Digital endpointsOther names

3,374 CLINICAL SOCIAL WORKER in FL

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Provider Addresses for KATHERINE L BLACK (LCSW)

  • 14, Kingsley Avenue, Orange Park, Clay County, Florida, 32073, United States

    ORANGE PARK, FL 320734570

    Phone: (904) 264-6977

    Fax: (904) 269-0870

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-02-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190226002975IClinical Social WorkerFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90837Psychotherapy, 1 hour31137$0
View full utilization report →

Insurance plans in this area (ZIP 32073)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9133441421View full group profile
NameSpecialtyState
Mental Health CounselorFL
Psychiatry, Geriatric PsychiatryFL
Mental Health CounselorFL
Nurse PractitionerFL
Nurse PractitionerFL

Reviews

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Frequently asked questions

What unique ID ties claims to KATHERINE L BLACK (LCSW)?
NPI 1700342540 is assigned to KATHERINE L BLACK (LCSW) under the national enumeration system.
Is KATHERINE L BLACK (LCSW)'s NPI currently valid?
The extract we use shows KATHERINE L BLACK (LCSW) as active.
What field does KATHERINE L BLACK (LCSW) work in?
You can think of KATHERINE L BLACK (LCSW) as practicing within Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Where does public data place KATHERINE L BLACK (LCSW)?
The snapshot lists Orange Park, Florida for KATHERINE L BLACK (LCSW); download NPPES for the complete set.
How can I contact KATHERINE L BLACK (LCSW)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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