NPI 1003107731

Leah Black, LCSW

Practitioner Clinical Social Worker Jackson, WY

Practice location

Address: 310 E Broadway Ave, Jackson, WY 83001-8636
Phone: (307) 654-7003
Fax: (307) 224-4973
Mailing address: PO Box 13572, Jackson, WY 83002-3572

Registered specialties

Clinical Social Worker Primary

Behavioral Health & Social Service Providers Taxonomy 1041C0700X Licence LCSW-742 (WY)

Other Social Worker providers in Wyoming →

Registry record

NPI: 1003107731
Entity type: Individual
Sex (as registered): Female
NPI issued: 28 Apr 2011
Record last updated: 18 Feb 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.