Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MRS. DOMINIQUE JEROLDINE LEON BLACK, LCSW
ActiveMRS. DOMINIQUE JEROLDINE LEON BLACK, LCSW is a Clinical Social Worker healthcare provider located in JEFFERSONTON, Virginia. NPI 1225784556 is currently active in the NPPES registry. Verify at CMS.
Clinical Social Worker · JEFFERSONTON, VA
Registration Details
- NPI Number
- 1225784556
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Feb 24, 2022 (4.4588677529661 yrs)
- Last Updated
- Nov 2, 2023
- License
-
0904013714 (VA)
Practice Information
- Address
-
6216 SCOTTSVILLE RDJEFFERSONTON, VA, 227242342Browse VA providers · Browse ZIP 22724
- Phone
- 5402193247
- Primary Specialty
-
Clinical Social Worker
1041C0700X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.