CHRISTINE MARIE BLACK (MSW LCSW) – Clinical Social Worker, NPI 1073814828

CHRISTINE MARIE BLACK (MSW LCSW) is a healthcare provider. based in Festus, Missouri. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials MSW LCSW. They hold a License No. 2008009619 (MO). The NPI Number for CHRISTINE MARIE BLACK (MSW LCSW) is 1073814828

Main info

Female
Sole Proprietor
20 Years Of Experience
Accepts Medicare Assignment
Name
CHRISTINE MARIE BLACK (MSW LCSW)
NPI
1073814828
Phone
(636) 931-4206
Address
807 COLLINS DR
Enumeration Date
10 November 2010
Last Update Date
12 August 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3142063700
Graduation Year
2006 (20 years ago)
PAC ID
1850551532
Group Practice PAC ID
1153225271
Professional Enrollment ID
I20120404000876
Address ID
MO631391101SA3309XBLVD400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:15State licenses:1Digital endpointsOther names

1,245 CLINICAL SOCIAL WORKER in MO

Provider Addresses for CHRISTINE MARIE BLACK (MSW LCSW)

  • 807 COLLINS DR

    FESTUS, MO 630282346

    Phone: (636) 931-4206

    Fax: (636) 931-5774

    Type: Mailing

  • 3309 S KINGSHIGHWAY BLVD

    SAINT LOUIS, MO 631391101

    Phone: (314) 206-3700

    Fax: (314) 206-3708

    Type: Mailing

  • 1 KWAN PLZ

    POTOSI, MO 636641435

    Phone: (573) 438-0751

    Fax: (573) 438-5460

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-04-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120404000876IClinical Social WorkerMOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 63028)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1153225271View full group profile
NameSpecialtyState
Clinical Social WorkerMO
P S Y C H I A T R YMO
Clinical Social WorkerMO
Mental Health CounselorMO
P S Y C H I A T R YMO
Clinical Social WorkerMO
Clinical Social WorkerMO
Mental Health CounselorMO
P S Y C H I A T R YOH
Clinical Social WorkerVA

Reviews

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Frequently asked questions

What is the registry number for CHRISTINE MARIE BLACK (MSW LCSW)?
The registry entry for CHRISTINE MARIE BLACK (MSW LCSW) shows NPI 1073814828.
Should I treat CHRISTINE MARIE BLACK (MSW LCSW) as an active provider?
Patients and plans typically see CHRISTINE MARIE BLACK (MSW LCSW) as active in the national extract.
What does the directory say CHRISTINE MARIE BLACK (MSW LCSW) does?
Insurance directories may phrase it differently, but here CHRISTINE MARIE BLACK (MSW LCSW) maps to Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Is CHRISTINE MARIE BLACK (MSW LCSW) tied to Festus, Missouri?
If you are local to Festus, Missouri, CHRISTINE MARIE BLACK (MSW LCSW) may be relevant to your search.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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