Sandra E Black, LCSW in Port Washington, WI - Social Worker

Sandra E Black, LCSW is a Social Worker - Clinical based in Port Washington, Wisconsin. Sandra E Black is licensed to practice in Wisconsin (license number 1607-123) and her current practice location is 1317 W Grand Ave, Port Washington, Wisconsin. She can be reached at her office (for appointments etc.) via phone at (262) 284-5789.

NPI number for Sandra E Black is 1407803489 and her current mailing address is 1317 W Grand Ave, Port Washington, Wisconsin. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1407803489.

Contact Information

	Sandra E Black, LCSW
	1317 W Grand Ave, Port Washington, WI 53074-2075
	(262) 284-5789
	(262) 284-5907

Healthcare Provider's Profile

Full Name	Sandra E Black
Gender	Female
Speciality	Social Worker - Clinical
Location	1317 W Grand Ave, Port Washington, Wisconsin
Accepts Medicare Assignments	Does not participate in Medicare Program. She may not accept medicare assignment.

NPI Data:

NPI Number: 1407803489
Provider Enumeration Date: 05/27/2006
Last Update Date: 10/18/2007

Medical Identifiers

Medical identifiers for Sandra E Black such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1407803489	NPI	-	NPPES
39730600	Medicaid	WI

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	1607-123 (Wisconsin)	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. Sandra E 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
Sandra E Black, LCSW 1317 W Grand Ave, Port Washington, WI 53074-2075 Ph: (262) 284-5789	Sandra E Black, LCSW 1317 W Grand Ave, Port Washington, WI 53074-2075 Ph: (262) 284-5789

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Social Worker in Port Washington, WI

Renee M Keranen, MSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 121 W Main St, Port Washington, WI 53074 Phone: 262-284-8133 Fax: 262-284-8104
Roger Blanchard, MSW, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 101 E Pier St, Port Washington, WI 53074 Phone: 262-284-3117 Fax: 262-284-3087
Sandra Jacques, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 121 W Main St, Suite 350, Port Washington, WI 53074 Phone: 262-284-8130 Fax: 262-284-8104
Mrs. Deanna Schultz-depies, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 121 W Main St, #350, Port Washington, WI 53074 Phone: 262-284-8140 Fax: 262-284-8104
Timothy J Shininger, LCSW LMFT Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1317 W Grand Ave, Port Washington, WI 53074 Phone: 262-284-5789 Fax: 262-284-5907
Lorene Menchaca, LCSW, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 101 E Pier St, Port Washington, WI 53074 Phone: 262-284-3117 Fax: 262-284-3087

Sandra E Black, LCSW - Clinical Social Worker in Port Washington, WI