Black, Joel M
Black, Joel M is an sole proprietor health care provider with primary practice located at 3324 Rue Royale St , Saint Charles MO 63301-8321. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Black, Joel M can be contacted via phone (314) 643-6172.Contact Information
Primary practice address
3324 Rue Royale St
Saint Charles MO 63301-8321
Phone: (314) 643-6172
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 2019040488 | Missouri |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 149.021964 | Illinois |
Profile Details
| NPI number | 1144889650 |
|---|---|
| LBN Legal business name | Black, Joel M |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 8th, 2019 |
| Last updated | Sep 12th, 2025 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1144889650 | NPPES |
| Missouri | MEDICAID | 490074023 |
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