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Deactivated NPI 1437703873 Deactivated / Inactive NPI Male Practitioner

Michael Anthony Black , MS

Counselor • Middletown, CT

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Michael Black has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 24, 2019
NPI Deactivation Date January 01, 2026
Total Practice Duration ~7 Years of Practice (2019 – 2026)

Professional Overview & Biography Verified Profile Summary

Michael Black, MS was a registered Counselor practicing in Middletown, CT. Throughout an active medical career spanning 7 years, Michael Black provided care at the practice location at 230 MAIN STREET EXT until profile deactivation on 2026-01-01.

Practice Location & Contact Primary Location

Practice Address

230 Main Street Ext

Middletown, CT 064574470

Telephone 8603435303
Fax 8603443339
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor in Middletown, CT

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 9.3 Yrs
State Avg: 13.9 Yrs
Regional Practice Density
30 Specialists

Practicing in Middletown, CT (1438 Statewide)

Telehealth Adoption Rate
3.3% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Counselor Primary Specialty

NUCC Taxonomy Code: 101Y00000X

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

7 Associated Practitioners
Emily Forman

Counselor - Mental Health

NPI 1104372879
Monika Obermeier , LPC

Counselor - Mental Health

NPI 1184407645

Licensed Professional Counselor

Janice Juliano , LCSW

Social Worker - Clinical

NPI 1184831620

Licensed Clinical Social Worker

Avrey Juntilla-Smith , LMFT-A

Marriage & Family Therapist

NPI 1366228306

LMFTA

Ted Johanson , MA

Counselor - Mental Health

NPI 1417262510

Master of Arts

NPI 1487978805

Licensed Professional Counselor

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated January 01, 2026

Record deactivated on January 01, 2026

NPI Profile Active July 24, 2019

NPI status registered as active in NPPES database

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Updated Practice Location July 24, 2019

Registered at 230 MAIN STREET EXT, MIDDLETOWN, CT 064574470 (Tel: 8603435303)

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Updated Business Mailing Address July 24, 2019

Registered at 230 MAIN STREET EXT, MIDDLETOWN, CT 064574470 (Tel: 8603435303)

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Provider Name / Credentials Updated July 24, 2019

Recorded as MICHAEL BLACK, MS

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 24, 2019

Counselor

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Initial NPI Registration & Enumeration July 24, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1437703873
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 24, 2019
Last Update: July 24, 2019
Deactivation Date: January 01, 2026

Mailing Address

230 Main Street Ext

Middletown, CT 064574470

Phone: 8603435303

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.