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Individual
MELISSA KATHERINE BLACK
Active
Individual
MELISSA KATHERINE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
ASW59562
CA
1041C0700X
Clinical Social Worker
Primary
LCSW79673
CA
Other
Enumeration date
10/10/2007
Last updated
10/13/2017
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