National Provider Identifier

Ruth Theresa Black, LCSW-R

Ruth Theresa Black, LCSW-R is listed in the NPPES registry with a primary specialty of Clinical Social Worker in Buffalo, NY and a listed phone number of (716) 876-8126.

NPI 1437260692Buffalo, NYClinical Social Worker

Profile Overview

NPI
1437260692
Provider Type
Individual
Primary Specialty
Clinical Social Worker
Enumeration Date
August 31, 2006
Last Updated
July 08, 2007

Practice Location

  • 29 Tennyson Ave
  • Buffalo, NY 14216

Phone: (716) 876-8126

Specialties

  • Clinical Social Worker (1041C0700X)
Full Record
NPI
1437260692
Entity Type
Individual
Last Name
Black
First Name
Ruth
Middle Name
Theresa
Credential
LCSW-R
Provider Other Last Name
Wilson
Provider Other First Name
Ruth
Provider Other Middle Name
Theresa
Provider Other Last Name Type Code
5
Mailing Street Address
29 Tennyson Ave
Mailing City
Buffalo
Mailing State
NY
Mailing ZIP Code
14216
Mailing Country
US
Mailing Phone
(716) 876-8126
Mailing Fax
(716) 876-8126
Practice Street Address
29 Tennyson Ave
Practice City
Buffalo
Practice State
NY
Practice ZIP Code
14216
Practice Country
US
Practice Phone
(716) 876-8126
Practice Fax
(716) 876-8126
Enumeration Date
August 31, 2006
Last Updated
July 08, 2007
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Clinical Social Worker (1041C0700X)
Other Identifiers
7400103 (Empire), 110342 (Value Options), 030194 (Ghi), 00510617003 (BCBS)