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Individual

JAYLEA BLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4320 VINE STREET, UNIT 80 - PMB 191, HAYS, KS 67601-3551
(785) 734-0292
Mailing address
4320 VINE STREET, UNIT 80 - PMB 191, HAYS, KS 67601-3551
(785) 734-0292

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
752
KS
1041C0700X
Clinical Social Worker
Primary
05319
KS
1041C0700X
Clinical Social Worker
CSW.09927568
CO

Other

Enumeration date
06/12/2018
Last updated
03/11/2024
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