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

Individual provider Speech-Language Pathologist · NPI 1164683033

Tyler Black, CCC-SLP is a Speech-Language Pathologist in Winston Salem, North Carolina. Licensed in North Carolina and Virginia. Registered with an NPI since 2008.

Licensed in
NC, VA
In the registry since
2008
Specialties on file
2
What do these letters mean?
CCC-SLP — Certificate of Clinical Competence in Speech-Language Pathology
A speech-language pathologist certified by ASHA.

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Practice location Address checks out

185 Charlois Blvd
Winston Salem, NC 27103-1521
Phone: (336) 725-0222
Fax: (877) 725-0222
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 9027 (NC)
Speech-Language Pathologist Taxonomy 235Z00000X · Licence 2202005520 (VA)

Record details

NPI number1164683033
Entity typeIndividual (Type 1)
GenderFemale
Credentials CCC-SLP
Sole proprietorNo
NPI enumeratedJune 23, 2008
Last updated in NPPESOctober 7, 2014
Mailing address185 Charlois Blvd, Winston Salem, NC 27103-1521

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