Leah Black
Clinical Social Worker
310 E Broadway Ave
Jackson
, Wyoming 83001-8636
Leah Black
Clinical Social Worker
310 E Broadway Ave
Jackson
, Wyoming 83001-8636
(307) 224-4973
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About
Features
Specialties
- Clinical Social Worker
Languages spoken
- English
Location
First Address
- Leah Black
- Po Box 13572
- Jackson, WY
- Zip : 83002-3572
- Fax : (307) 224-4973
- Phone : (307) 654-7003
Second Address
- Leah Black
- 310 E Broadway Ave
- Jackson, WY
- Zip : 83001-8636
- Fax : (307) 224-4973
- Phone : (307) 654-7003
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1041C0700X | Clinical Social Worker | LCSW-742 | WY |
National Provider Identifier
| NPI | 1003107731 |
|---|---|
| Provider Name | Leah Black |
| First Address | Jackson, WY 83002-3572 |
| Second Address | Jackson, WY 83001-8636 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 28/04/2011 |
| Last Update Date | 18/02/2015 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 117699400 | (05) | WY |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.