Provider Demographics
NPI:1841185055
Name:BLACK, KARI JULANE (MSW, LICSW, LADC)
Entity type:Individual
Prefix:MS
First Name:KARI
Middle Name:JULANE
Last Name:BLACK
Suffix:
Gender:F
Credentials:MSW, LICSW, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2318 VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55057-3191
Mailing Address - Country:US
Mailing Address - Phone:507-491-1360
Mailing Address - Fax:
Practice Address - Street 1:2318 VALLEY DR
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55057-3191
Practice Address - Country:US
Practice Address - Phone:507-491-1360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN307062101YA0400X
MN5010241041S0200X
MN278671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool