BRENDA BLACK LCSW PC
NPI 1265743637
Social Worker - Clinical in Evanston, IL
About Brenda Black Lcsw Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BRENDA BLACK LCSW PC (NPI 1265743637) is a healthcare organization registered as a clinical in Evanston, Illinois and active in the NPI registry since June 2010. The organization lists Brenda N Black, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Brenda Black Lcsw Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Brenda Black Lcsw PC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Brenda Black Lcsw PC's NPI number?
The NPI number for Brenda Black Lcsw PC is 1265743637. It was assigned to this organization in the NPPES registry on June 30, 2010.
Where is Brenda Black Lcsw PC located?
Brenda Black Lcsw PC is located at 717 Main St Suite 2E, Evanston, IL 60202. The listed phone number is (312) 718-6996.
What is Brenda Black Lcsw PC's specialty?
The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.
Is Brenda Black Lcsw PC enrolled in Medicare?
Yes. Brenda Black Lcsw PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Brenda Black Lcsw PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Brenda Black Lcsw PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Brenda Black Lcsw PC was last updated on June 23, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Brenda Black Lcsw Pc · NPI 1265743637
Clinical organization in Evanston, Illinois. Organization record, active in the CMS NPPES registry since June 30, 2010.
## Identity
- **NPI:** 1265743637 (Entity type: Organization)
- **Enumerated:** June 30, 2010
- **Primary specialty:** Social Worker - Clinical · taxonomy 1041C0700X
- **Organization subpart:** No
- **Authorized official:** Brenda Black, OWNER
## Practice location
- **Address:** 717 MAIN ST, SUITE 2E, Evanston, IL 60202-1701
- **Phone:** (312) 718-6996
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Clinical Social Worker) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 23, 2011
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Source: [NPI Profile](https://npiprofile.com/npi/1265743637) · Data from the CMS NPPES public registry.