Mrs Mary Ellen Black, LISW LPCC is a
Social Worker - Clinical based in Mount Vernon, Ohio. Mrs Mary Ellen Black is licensed to practice in Ohio (license number I0000799) and her current practice location is
102 East Gambier Street, Mount Vernon, Ohio. She can be reached at her office (for appointments etc.) via phone at
(740) 392-5416.
NPI number for Mrs Mary Ellen Black is 1669532107 and her current mailing address is 102 East Gambier Street, Mount Vernon, Ohio. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1669532107.
Healthcare Provider's Profile
| Full Name | Mrs Mary Ellen Black |
|---|
| Gender | Female |
|---|
| Speciality | Social Worker - Clinical |
|---|
| Location | 102 East Gambier Street, Mount Vernon, Ohio |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1669532107
- Provider Enumeration Date: 12/12/2006
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Mrs Mary Ellen Black such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1669532107 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YP2500X | Counselor - Professional | E0000717 (Ohio) | Primary |
| 1041C0700X | Social Worker - Clinical | I0000799 (Ohio) | 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 Mary Ellen 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 Mary Ellen Black, LISW LPCC
102 East Gambier Street,
Mount Vernon, OH 43050
Ph: (740) 392-5416 | Mrs Mary Ellen Black, LISW LPCC
102 East Gambier Street,
Mount Vernon, OH 43050
Ph: (740) 392-5416 |
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