NPIMap

Organization Active NPI

Child & Family Counseling Group

  • Marriage & Family Therapist
  • San Jose, CA
National Provider Identifier
1114659984
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
CHILD & FAMILY COUNSELING GROUP
Practice address
3880 S Bascom Ave Ste 115
San Jose, CA 95124-2600
Phone
(408) 351-1044
NPI assigned
Jun 29, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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

Authorized official

Name
Beth ProudfootNPI 1265897979
Title
Founder/ LMFT
Phone
(408) 351-1044

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X Primary

Addresses

Primary practice location

3880 S Bascom Ave Ste 115
San Jose, CA 95124-2600

Mailing address

3880 S Bascom Ave Ste 115
San Jose, CA 95124-2600

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL laptop Direct
CONNECT URL laptop

National Provider Directory

National Provider Directory

Locations

3880 S Bascom Ave
Ste 115
San Jose, CA 95124
Phone (408) 351-1044

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1656460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656460800000",
    "number": "1114659984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3880 S BASCOM AVE STE 115",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951242600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3880 S BASCOM AVE STE 115",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951242600",
            "telephone_number": "408-351-1044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILD & FAMILY COUNSELING GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-29",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A",
        "authorized_official_last_name": "PROUDFOOT",
        "authorized_official_first_name": "BETH",
        "authorized_official_title_or_position": "FOUNDER/ LMFT",
        "authorized_official_telephone_number": "408-351-1044"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "laptop",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3880 S Bascom Ave Ste 115",
            "city": "San Jose",
            "state": "CA",
            "country_code": "US",
            "postal_code": "951242600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "laptop",
            "affiliation": "N",
            "address_1": "3880 S Bascom Ave Ste 115",
            "city": "San Jose",
            "state": "CA",
            "country_code": "US",
            "postal_code": "951242600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.