Mrs Alexa Marie Black, LCSW, PMH-C is a
Social Worker - Clinical based in Salt Lake City, Utah. Mrs Alexa Marie Black is licensed to practice in Utah (license number 11599470-3501) and her current practice location is
100 N Mario Capecchi Dr, Salt Lake City, Utah. She can be reached at her office (for appointments etc.) via phone at
(801) 662-5529.
NPI number for Mrs Alexa Marie Black is 1255998589 and her current mailing address is 915 Stonehenge Dr, North Salt Lake, Utah. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1255998589.
Healthcare Provider's Profile
Full Name | Mrs Alexa Marie Black |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 100 N Mario Capecchi Dr, Salt Lake City, Utah |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1255998589
- Provider Enumeration Date: 05/22/2019
- Last Update Date: 04/20/2024
Medical Identifiers
Medical identifiers for Mrs Alexa Marie Black such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1255998589 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101Y00000X | Counselor | (* (Not Available)) | Secondary |
1041C0700X | Social Worker - Clinical | 11599470-3501 (Utah) | 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 Alexa Marie 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 Alexa Marie Black, LCSW, PMH-C 915 Stonehenge Dr, North Salt Lake, UT 84054-6001 Ph: (801) 440-0215 | Mrs Alexa Marie Black, LCSW, PMH-C 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 Ph: (801) 662-5529 |
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