Gail Rene Black, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC33588 Issued in CA

Practice address

740 Front St Ste 350
Santa Cruz, CA 95060-4562

Phone

(831) 425-3378

NPI assigned

Nov 8, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Gail Rene Walters Former name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1226102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381276800000",
    "number": "1215181995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 FRONT ST STE 350",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950604562",
            "telephone_number": "831-425-3378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 FRONT ST STE 350",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950604562",
            "telephone_number": "831-425-3378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "GAIL",
        "middle_name": "RENE",
        "name_prefix": "Mrs.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-08",
        "last_updated": "2013-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC33588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GAIL",
            "last_name": "WALTERS",
            "middle_name": "RENE",
            "credential": "MFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daniel Brian Bishop
• Natalie L. Bispo
• Jeffrey Blake Bissell
• Sondra Bitonti, LCSW
• Randi Bittner, LCSW
• Lisa Black, PSYD
• Mary A Black, L.AC, MTCM, DIPL.O.M
• Carolyn Sue Blackman, RN, LCSW
• Sara Blackstorm Atton, DTCM
• Craig Blackwell, MD

• Marriage & Family Therapist in Santa Cruz, CA
• Providers in Santa Cruz, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.