| Sandra E Black, LCSW | |
|
1317 W Grand Ave, Port Washington, WI 53074-2075 | |
| (262) 284-5789 | |
| (262) 284-5907 |
| Full Name | Sandra E Black |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 1317 W Grand Ave, Port Washington, Wisconsin |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407803489 | NPI | - | NPPES |
| 39730600 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 1607-123 (Wisconsin) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Sandra E Black, LCSW 1317 W Grand Ave, Port Washington, WI 53074-2075 Ph: (262) 284-5789 | Sandra E Black, LCSW 1317 W Grand Ave, Port Washington, WI 53074-2075 Ph: (262) 284-5789 |
Renee M Keranen, MSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 121 W Main St, Port Washington, WI 53074 Phone: 262-284-8133 Fax: 262-284-8104 | |
Roger Blanchard, MSW, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 101 E Pier St, Port Washington, WI 53074 Phone: 262-284-3117 Fax: 262-284-3087 | |
Sandra Jacques, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 121 W Main St, Suite 350, Port Washington, WI 53074 Phone: 262-284-8130 Fax: 262-284-8104 | |
Mrs. Deanna Schultz-depies, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 121 W Main St, #350, Port Washington, WI 53074 Phone: 262-284-8140 Fax: 262-284-8104 | |
Timothy J Shininger, LCSW LMFT Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1317 W Grand Ave, Port Washington, WI 53074 Phone: 262-284-5789 Fax: 262-284-5907 | |
Lorene Menchaca, LCSW, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 101 E Pier St, Port Washington, WI 53074 Phone: 262-284-3117 Fax: 262-284-3087 |