Individual
MICHAEL BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW, CACIII
Contact information
Practice address
1212 S BROADWAY, SUITE 200, DENVER, CO 80210-1582
(303) 957-7567
(303) 934-1262
Mailing address
1212 S BROADWAY, SUITE 200, DENVER, CO 80210-1582
(303) 957-7567
(303) 934-1262
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACC-7098
CO
1041C0700X
Clinical Social Worker
CSW-1229
CO
Other
Enumeration date
03/08/2011
Last updated
03/08/2011
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