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

Individual provider Occupational Therapist · NPI 1942550405

Kelly Black, OTR/L is an Occupational Therapist in Fayetteville, North Carolina. Works from 2 locations. Licensed in Illinois and North Carolina.

Licensed in
IL, NC
In the registry since
2012
Specialties on file
2
What do these letters mean?
OTR/L — Occupational Therapist, Registered and Licensed
An occupational therapist who is both nationally registered and state licensed.

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Practice location Address checks out

4101 Raeford Rd
Fayetteville, NC 28304-4114
Phone: (910) 488-2120
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 5000 S 5th Ave, Hines, IL 60141-3030 — (708) 202-8387

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 11328 (NC)
Occupational Therapist Taxonomy 225X00000X · Licence 056.009759 (IL)

Record details

NPI number1942550405
Entity typeIndividual (Type 1)
GenderFemale
Credentials OTR/L
Sole proprietorNo
NPI enumeratedSeptember 12, 2012
Last updated in NPPESSeptember 17, 2020
Certification dateSeptember 17, 2020

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