Christine Marie Black, MSW LCSW | |
1 Kwan Plz, Potosi, MO 63664-1435 | |
(573) 438-0751 | |
(573) 438-5460 |
Full Name | Christine Marie Black |
---|---|
Gender | Female |
Speciality | Social Worker - Clinical |
Location | 1 Kwan Plz, Potosi, Missouri |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1073814828 | NPI | - | NPPES |
2008009619 | Other | MO | STATE LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 2008009619 (Missouri) | Primary |
Entity Name | Bjc Behavioral Health |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1669485868 PECOS PAC ID: 1153225271 Enrollment ID: O20031120000936 |
Entity Name | Bjc Behavioral Health |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1801807847 PECOS PAC ID: 1153225271 Enrollment ID: O20040414000854 |
Mailing Address | Practice Location Address |
---|---|
Christine Marie Black, MSW LCSW 3309 S Kingshighway Blvd, Saint Louis, MO 63139-1101 Ph: (314) 206-3700 | Christine Marie Black, MSW LCSW 1 Kwan Plz, Potosi, MO 63664-1435 Ph: (573) 438-0751 |
Ms. Charlotte Ann Edelen, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 600 Purcell Rd, Suite B, Potosi, MO 63664 Phone: 573-438-9355 Fax: 573-438-7892 | |
Melissa Gail Benson, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1 Southtowne Dr, Potosi, MO 63664 Phone: 573-438-8381 | |
Mrs. Terra Renee Graves, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 1 Southtowne Dr, Potosi, MO 63664 Phone: 573-438-9355 | |
Melinda Kaye Fox, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1 Kwan Plz, Potosi, MO 63664 Phone: 573-438-1899 Fax: 573-438-5460 | |
Carrie Marie Mercer, MSW, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1 Kwan Plz, Potosi, MO 63664 Phone: 573-438-5451 Fax: 573-438-0007 | |
Bethany Renae Aubuchon, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1 Southtowne Dr, Potosi, MO 63664 Phone: 573-438-9355 |