Individual
NICOLE BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5505 CARRICK CT, COLUMBIA, MO 65203-5156
(610) 675-5326
Mailing address
5505 CARRICK CT, COLUMBIA, MO 65203-5156
(610) 675-5326
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2025034325
MO
Other
Enumeration date
07/12/2023
Last updated
09/11/2025
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