Conner James Black, PHD
NPI 1700652948ActiveIndividual· Psychologist· Riverside, RI
Psychologist (PHD) in Riverside, Rhode Island, licensed in RI, with an NPI issued in November 2023. Enrolled in Medicare as practitioner - clinical psychologist.
Overview
| NPI | 1700652948 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PHD |
| Sole proprietor | No |
| NPI issued | Nov 29, 2023 |
| Last updated in NPPES | Sep 16, 2024 |
| Certified by provider | Sep 16, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | PS02300 | RI |
| Psychologist | 103T00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Psychologist (RI) |
|---|
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