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

John W Black Jr., MS, LPA

Individual provider Professional Counselor · NPI 1457401945

John W Black Jr., MS, LPA is a Mental Health Counselor in Georgetown, Kentucky. Qualified in 1992, 34 years ago. Licensed in Kentucky.

Years since qualifying
34
Licensed in
KY
In the registry since
2007
What do these letters mean?
MS — Master of Science
A graduate science degree.

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Practice location Address checks out

110 Roach St
Georgetown, KY 40324-9393
Phone: (859) 253-1686
Fax: (859) 254-2743
Show map & directions

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

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 241827 (KY)

Record details

NPI number1457401945
Entity typeIndividual (Type 1)
GenderMale
Credentials MS , LPA
Sole proprietorNo
NPI enumeratedJanuary 10, 2007
Last updated in NPPESJuly 22, 2026
Certification dateJuly 22, 2026

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 1992 (34 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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