LEORA ELIZABETH BLACK (PH.D.) – Mental Health Counselor, NPI 1003986407

LEORA ELIZABETH BLACK (PH.D.) is a healthcare provider. based in Colchester, Vermont. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials PH.D.. They hold a License No. 068-0000067 (VT). The NPI Number for LEORA ELIZABETH BLACK (PH.D.) is 1003986407

Main info

Female
Sole Proprietor
37 Years Of Experience
Accepts Medicare Assignment
Name
LEORA ELIZABETH BLACK (PH.D.)
NPI
1003986407
Phone
(802) 264-5333
Address
525 HERCULES DR
Enumeration Date
9 November 2006
Last Update Date
13 December 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8022645333
Graduation Year
1989 (37 years ago)
PAC ID
9335582048
Professional Enrollment ID
I20240209001952
Address ID
VT054468113CO525XXDRXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

357 MENTAL HEALTH COUNSELOR in VT

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Provider Addresses for LEORA ELIZABETH BLACK (PH.D.)

  • 525, Hercules Drive, Colchester, Chittenden County, Vermont, 05439, United States

    SUITE 1A

    COLCHESTER, VT 054465993

    Phone: (802) 264-5333

    Fax: (802) 264-5338

    Type: Location

  • 231, Country Meadows, Colchester, Chittenden County, Vermont, 05446, United States

    COLCHESTER, VT 054467072

    Phone: (802) 264-5333

    Fax: (802) 264-5338

    Type: Mailing

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: 2024-02-09

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
I20240209001952IMental Health CounselorVTTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 05446)

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Reviews

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Frequently asked questions

Does LEORA ELIZABETH BLACK (PH.D.) have a public NPI I can cite?
Public records show LEORA ELIZABETH BLACK (PH.D.) under NPI 1003986407.
Is LEORA ELIZABETH BLACK (PH.D.)'s NPI status active today?
Active status means LEORA ELIZABETH BLACK (PH.D.)'s NPI record is not deactivated in the public file.
Which specialty label fits LEORA ELIZABETH BLACK (PH.D.)?
NPPES ties LEORA ELIZABETH BLACK (PH.D.) to Mental Health Counselor in the taxonomy section. Clinical services aligned with this taxonomy classification.
What city is tied to LEORA ELIZABETH BLACK (PH.D.)?
The directory associates LEORA ELIZABETH BLACK (PH.D.) with Colchester, Vermont. Check all listed addresses for suites or satellite offices.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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