Lance H Black, LBSW

Individual provider Active NPI School Social Worker · Aztec, NM

NPI 1497632095 · NPPES record last updated Aug 18, 2025

Key facts

NPI
1497632095
Entity type
Individual (NPI type 1)
Primary specialty
School Social Worker 1041S0200X
License
SWB-2025-0657 (NM)
Practice address
455 N Light Plant Rd
Aztec, NM 87410-1517
Phone
(505) 334-6102
NPI assigned
Aug 18, 2025
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)
No

State licenses

LicenseStateTypeSpecialty
SWB-2025-0657NMMDSchool Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X SWB-2025-0657 NM Yes

Addresses

Primary practice location

455 N Light Plant Rd
Aztec, NM 87410-1517

Mailing address

4 Road 3459
Flora Vista, NM 87415-9667
Phone (505) 278-3400

Other providers in Aztec, NM

All providers in Aztec, NM · School Social Worker in New Mexico

Sources for this page

Verify at the official NPI Registry.