Individual
BENJAMIN ROBERT BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
564 6TH ST, SAN FRANCISCO, CA 94103-4708
(650) 503-4589
Mailing address
564 6TH ST, SAN FRANCISCO, CA 94103-4708
(650) 372-4080
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
ASW85095
CA
1041C0700X
Clinical Social Worker
Primary
LCSW100464
CA
Other
Enumeration date
05/22/2018
Last updated
02/04/2022
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