Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Leon B Black, MSWLCSWCCBTCPTP

Individual provider Clinical Social Worker · NPI 1790793198

Leon B Black, MSWLCSWCCBTCPTP is a Clinical Social Worker in Rockford, Illinois. Qualified in 1992, 34 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
34
Licensed in
IL
In the registry since
2006
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Practice location Address checks out

7210 E State St Ste 102
Rockford, IL 61108-1201
Phone: (815) 877-8567
Fax: (815) 877-8567
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 149.005967 (IL)

Record details

NPI number1790793198
Entity typeIndividual (Type 1)
GenderMale
Credentials MSWLCSWCCBTCPTP
Sole proprietorYes
NPI enumeratedAugust 3, 2006
Last updated in NPPESNovember 6, 2025
Certification dateNovember 6, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1992 (34 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Rockford