NPIMap

Organization Active NPI

TLC Child & Family Services

  • Adolescent and Children Mental Health Clinic/Center
  • Sebastopol, CA
National Provider Identifier
1073131942
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
TLC CHILD & FAMILY SERVICES
Practice address
1800 Gravenstein Hwy N BLDG Ef
Sebastopol, CA 95472-2607
Phone
(707) 634-9050
NPI assigned
Jul 8, 2020
Last updated
Jun 1, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Alexandra Mondragon
Title
Account Manager
Phone
(707) 634-9037

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X NU
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU Primary

Addresses

Primary practice location

1800 Gravenstein Hwy N BLDG Ef
Sebastopol, CA 95472-2607

Mailing address

1800 Gravenstein Hwy N.
Sebastopol, CA 95472-2607

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sfette@tlc4kids.org Direct

National Provider Directory

National Provider Directory
Tax ID family
TLC Child and Family Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 34

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 34

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654041600000",
    "number": "1073131942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 GRAVENSTEIN HWY N.",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954722607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 GRAVENSTEIN HWY N BLDG EF",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954722607",
            "telephone_number": "707-634-9050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TLC CHILD & FAMILY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-08",
        "last_updated": "2022-06-01",
        "certification_date": "2022-05-31",
        "status": "A",
        "authorized_official_last_name": "MONDRAGON",
        "authorized_official_first_name": "ALEXANDRA",
        "authorized_official_title_or_position": "ACCOUNT MANAGER",
        "authorized_official_telephone_number": "707-634-9037"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sfette@tlc4kids.org",
            "affiliation": "N",
            "endpointDescription": "sfette@tlc4kids.org",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1800 Gravenstein Hwy N Bldg Ef",
            "city": "Sebastopol",
            "state": "CA",
            "country_code": "US",
            "postal_code": "954722607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sebastopol, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.