Sandra E Black is a Clinical in Port Washington, Wisconsin. Sandra E Black practices all healthcare services and medical treatments related to Clinical. The NPI Number for Sandra E Black is 1407803489. The last update date is 2007-10-18.
Sandra E Black's current location address is 1317 W Grand Ave, Port Washington, Wisconsin. You can contact this provider via phone number 2622845789 and fax number 2622845907. The mailing address for Sandra E Black is 1317 W Grand Ave, Port Washington, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Sandra E Black |
|---|---|
| Address | 1317 W Grand Ave, Port Washington, Wisconsin |
| Phone Number | 2622845789 |
| Fax Number | 2622845907 |
| Sole Proprietor | N |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1407803489 |
|---|---|
| Provider Enumeration Date | 2006-05-27 |
| Last Updated Date | 2007-10-18 |
Provider Mailing Address Detail
| Address | 1317 W Grand Ave |
|---|---|
| City | Port Washington |
| State | Wisconsin (WI) |
| Post Code | 530742075 |
| Phone Number | 2622845789 |
| Fax Number | 2622845907 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 1607-123 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 39730600 | WI | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Sandra E Black?
The Sandra E Black has been issued the NPI (National Provider Identifier) 1407803489 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you share the physical location details of Sandra E Black?
The Sandra E Black is situated at 1317 W Grand Ave, in the city of Port Washington, state of WI, with the zip code 530742075.
What is the Sandra E Black's specialty and taxonomy code?
The Sandra E Black's specialty is Clinical, and the corresponding taxonomy code is 1041C0700X.
On what date did Sandra E Black receive its 1407803489 assignment from the Centers for Medicare & Medicaid Services?
The Sandra E Black was assigned its 1407803489 on 2006-05-27, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information related to Sandra E Black most recently updated or refreshed?
The details pertaining to the Sandra E Black, including its address, specialty, and other relevant information, were last updated or refreshed on 2007-10-18.
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