Monica Fleetwood Black, LCSW, MSW, MA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34007844A Issued in IN

Practice address

350 S Landmark Ave
Bloomington, IN 47403-5001

Phone

(812) 676-4540

NPI assigned

Jan 26, 2019

Last updated

Sep 13, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1548460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568332800000",
    "number": "1629532304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 E THORNTON DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474016664",
            "telephone_number": "812-322-7583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 S LANDMARK AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474035001",
            "telephone_number": "812-676-4540"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "337 E Winslow Rd",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474017310",
            "country_code": "US",
            "telephone_number": "812-322-7583",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACK",
        "first_name": "MONICA",
        "middle_name": "FLEETWOOD",
        "name_prefix": "Mrs.",
        "credential": "LCSW, MSW, MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-26",
        "last_updated": "2019-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34007844A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Bisson
• Brianne Bitner
• Michael Joseph Blachut
• Jennifer Black, PA-C
• Lauren Elizabeth Black, MSN, RN, AGCNS-BC
• Robert E Black, ATC
• Sara E Black, LCSW
• Thomas Black, RBT
• Ann Elizabeth Blackwell, R.N,
• Julie Blad

• Clinical Social Worker in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2019; 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.