Black, Sandra E
Black, Sandra E is an individual health care provider with primary practice located at 1317 W Grand Ave , Port Washington WI 53074-2075. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Black, Sandra E can be contacted via phone (262) 284-5789.Contact Information
Primary practice address
1317 W Grand Ave
Port Washington WI 53074-2075
Phone: (262) 284-5789
Fax: (262) 284-5907
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 1607-123 | Wisconsin |
Profile Details
| NPI number | 1407803489 |
|---|---|
| LBN Legal business name | Black, Sandra E |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 27th, 2006 |
| Last updated | Oct 18th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407803489 | NPPES |
| Wisconsin | MEDICAID | 39730600 |
Popular Providers
-
Schultz-Depies, Deanna
121 W Main St #350, Port Washington WI 53074 -
Falk, Carol
101 E Pier St , Port Washington WI 53074-1939 -
Latton, Nancy
121 W Main St Ste 350, Port Washington WI 53074-1813 -
Keranen, Renee M
121 W Main St , Port Washington WI 53074-1813 -
Anderson, Dennis J
1317 W Grand Ave , Port Washington WI 53074-2075 -
Traxel, Jason W
121 W Main St , Port Washington WI 53074-1813 -
Blanchard, Roger
101 E Pier St , Port Washington WI 53074-1939 -
Menchaca, Lorene
101 E Pier St , Port Washington WI 53074-1939