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

Nickolas Black

Individual provider Counselor · NPI 1801345921

Nickolas Black is a Mental Health Counselor in Conway, Arkansas. Qualified in 2019, 7 years ago. Practices with Reding and Leach MD PLLC, a 62-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Arkansas.

Years since qualifying
7
Licensed in
AR
In the registry since
2016
Specialties on file
2

Practice location Address checks out

1022 Main St
Conway, AR 72032-5426
Phone: (501) 609-0400
Show map & directions

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

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence P2108000 (AR)
Counselor Taxonomy 101Y00000X

Record details

NPI number1801345921
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 30, 2016
Last updated in NPPESOctober 4, 2021
Certification dateOctober 4, 2021
Mailing address1022 Main St, Conway, AR 72032-5426

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Reding And Leach Md Pllc — 62 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Conway