Buck J Black, MSW, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

33005111A Issued in IN

Practice address

100 Saw Mill Rd
Ste 3102
Lafayette, IN 47905-5592

Phone

(765) 807-6778

Fax

(765) 807-6778

NPI assigned

Apr 28, 2008

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787443200000",
    "number": "1003081365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SAW MILL RD",
            "address_2": "STE 3102",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479055592",
            "telephone_number": "765-807-6778",
            "fax_number": "765-807-6778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SAW MILL RD",
            "address_2": "STE 3102",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479055592",
            "telephone_number": "765-807-6778",
            "fax_number": "765-807-6778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "BUCK",
        "middle_name": "J",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-28",
        "last_updated": "2026-08-23",
        "certification_date": "2026-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33005111A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://forms.hush.com/buck-black-therapy",
            "affiliation": "N",
            "endpointDescription": "Please add info/attachments",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Any",
            "address_1": "100 Saw Mill Rd",
            "address_2": "Ste 3102",
            "city": "Lafayette",
            "state": "IN",
            "country_code": "US",
            "postal_code": "479055592",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sara Jean Bishop, M.A.
• Brigitta Bittner, MD
• Hartmuth Bruno Bittner, M.D.
• BKD Productions, LLC
• BKD Productions, LLC
• Blackbird Clinical Services, LLC
• Holen Blackburn
• Susan Lynne Blakemore, FNP
• Annalise Bland, RBT
• John William Blank, MPT

• Social Worker in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.