Individual
NANCY BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3047 E MAIN RD STE 6, PORTSMOUTH, RI 02871-4262
(401) 683-7460
(401) 683-6212
Mailing address
3047 E MAIN RD STE 6, PORTSMOUTH, RI 02871-4262
(401) 683-7460
(401) 683-6212
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW00576
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3958-7
BCBS
RI
01
—
406244
BLUECHIP
RI
05
—
9003958
—
RI
Enumeration date
09/13/2006
Last updated
12/19/2021
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