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Individual

MS. JERRILYN BLACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
6645 GEORGIA AVE NW APT 201, WASHINGTON, DC 20012-2539
(817) 205-1283
Mailing address
3000 CONNECTICUT AVE NW STE 137, WASHINGTON, DC 20008-2549
(202) 643-1501

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC50081921
DC

Other

Enumeration date
06/09/2019
Last updated
01/19/2020
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