Active NPI
Jean Anne Black, LCSW
- Clinical Social Worker
- Winnsboro, LA
National Provider Identifier
1225097090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 5044
- Practice address
- 2104 Loop Rd
Suite C
Winnsboro, LA 71295-3338 - Phone
- (318) 435-4571
- NPI assigned
- Mar 21, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 5044 | LA | Primary |
Addresses
Primary practice location
2104 Loop Rd
Suite C
Winnsboro, LA 71295-3338
Mailing address
2104 Loop Rd
Suite C
Winnsboro, LA 71295-3338
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5044 | LA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314230400000",
"number": "1225097090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2104 LOOP RD",
"address_2": "SUITE C",
"city": "WINNSBORO",
"state": "LA",
"postal_code": "712953338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2104 LOOP RD",
"address_2": "SUITE C",
"city": "WINNSBORO",
"state": "LA",
"postal_code": "712953338",
"telephone_number": "318-435-4571"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "JEAN",
"middle_name": "ANNE",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-21",
"last_updated": "2011-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "LA",
"license": "5044",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winnsboro, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.