Mrs Dominique Jeroldine Leon Black, LCSW is a
Social Worker - Clinical based in Jeffersonton, Virginia. Mrs Dominique Jeroldine Leon Black is licensed to practice in Virginia (license number 0904013714) and her current practice location is
6216 Scottsville Rd, Jeffersonton, Virginia. She can be reached at her office (for appointments etc.) via phone at
(540) 219-3247.
NPI number for Mrs Dominique Jeroldine Leon Black is 1225784556 and her current mailing address is 6216 Scottsville Rd, Jeffersonton, Virginia. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1225784556.
Healthcare Provider's Profile
Full Name | Mrs Dominique Jeroldine Leon Black |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 6216 Scottsville Rd, Jeffersonton, Virginia |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1225784556
- Provider Enumeration Date: 02/24/2022
- Last Update Date: 11/02/2023
Medical Identifiers
Medical identifiers for Mrs Dominique Jeroldine Leon Black such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1225784556 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1041C0700X | Social Worker - Clinical | 0904013714 (Virginia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Dominique Jeroldine Leon Black is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mrs Dominique Jeroldine Leon Black, LCSW 6216 Scottsville Rd, Jeffersonton, VA 22724-2342 Ph: (540) 219-3247 | Mrs Dominique Jeroldine Leon Black, LCSW 6216 Scottsville Rd, Jeffersonton, VA 22724-2342 Ph: (540) 219-3247 |
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