Ryan Noel Black, L.S.W

Individual provider Active NPI Clinical Social Worker · Uniontown, OH

NPI 1093249104 · NPPES record last updated Nov 6, 2018

Key facts

NPI
1093249104
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
S.1601260 (OH)
Practice address
1560 Corporate Woods Pkwy
Uniontown, OH 44685-8730
Phone
(330) 208-2720
Fax
(330) 208-2721
NPI assigned
Apr 14, 2017
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
1601260OHMDSocial Worker
S.1601260OHMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 1601260 OH
Clinical Social Worker 1041C0700X S.1601260 OH Yes

Addresses

Primary practice location

1560 Corporate Woods Pkwy
Uniontown, OH 44685-8730

Mailing address

2215 E Waterloo Rd Ste 313
Akron, OH 44312-3856
Phone (330) 208-2720

Other identifiers

IdentifierTypeStateIssuer
0304759MedicaidOH

Other providers in Uniontown, OH

All providers in Uniontown, OH · Clinical Social Worker in Ohio

Sources for this page

Verify at the official NPI Registry.