Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Chyan A. Black

Individual provider Speech-Language Pathologist · NPI 1396569687

Chyan A. Black is a Qualified Speech Language Pathologist in Dacula, Georgia. Qualified in 2024, 2 years ago. Practices with Empowerme Rehabilitation Illinois LLC, a 367-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
2
Licensed in
GA
In the registry since
2024

Practice location Address checks out

3615 Braselton Hwy Ste 103
Dacula, GA 30019-5907
Phone: (678) 377-9634
Fax: (678) 377-9609
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence PCET004159 (GA)

Record details

NPI number1396569687
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 13, 2024
Last updated in NPPESNovember 13, 2024
Certification dateNovember 13, 2024
Mailing address3615 Braselton Hwy Ste 103, Dacula, GA 30019-5907

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyQUALIFIED SPEECH LANGUAGE PATHOLOGIST
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Empowerme Rehabilitation Illinois Llc — 367 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Dacula