Individual
BRENDA N BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1316 W ERIE ST, CHICAGO, IL 60642-5718
(312) 718-6996
(872) 813-5242
Mailing address
4256 N RAVENSWOOD AVE, SUITE 315, CHICAGO, IL 60613-1110
(312) 718-6996
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149013929
IL
Other
Enumeration date
03/26/2010
Last updated
10/30/2022
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