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Individual

JANICE BLACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
524 N TEJON ST, SUITE 3 - UPSTAIRS, COLORADO SPRINGS, CO 80903-4926
(719) 201-0887
(480) 275-3789
Mailing address
524 N TEJON ST, SUITE 3 - UPSTAIRS, COLORADO SPRINGS, CO 80903-4926
(719) 201-0887
(480) 275-3789

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW.09923269
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PENDING
CO
Enumeration date
08/03/2013
Last updated
08/03/2013
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