Johanna Catherine Black, MSW, LCSW is a
Social Worker - Clinical based in Boulder, Colorado. Johanna Catherine Black is licensed to practice in Colorado (license number CSW.09924311) and her current practice location is
1501 Yarmouth Ave, Boulder, Colorado. She can be reached at her office (for appointments etc.) via phone at
(413) 570-0534.
NPI number for Johanna Catherine Black is 1174908099 and her current mailing address is Po Box 725, Lyons, Colorado. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1174908099.
Healthcare Provider's Profile
| Full Name | Johanna Catherine Black |
|---|
| Gender | Female |
|---|
| Speciality | Social Worker - Clinical |
|---|
| Location | 1501 Yarmouth Ave, Boulder, Colorado |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1174908099
- Provider Enumeration Date: 07/21/2015
- Last Update Date: 09/13/2018
Medical Identifiers
Medical identifiers for Johanna Catherine Black such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1174908099 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | LSW.0009920730 (Colorado) | Secondary |
| 1041C0700X | Social Worker - Clinical | CSW.09924311 (Colorado) | 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. Johanna Catherine 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 |
|---|
Johanna Catherine Black, MSW, LCSW
Po Box 725,
Lyons, CO 80540-0725
Ph: (617) 971-7844 | Johanna Catherine Black, MSW, LCSW
1501 Yarmouth Ave,
Boulder, CO 80304-0564
Ph: (413) 570-0534 |
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