CDB Therapy, LLC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

CDB THERAPY, LLC

Practice address

925 W College Ave
State College, PA 16801-2804

Phone

(814) 380-4697

NPI assigned

Jan 31, 2020

Last updated

Jan 31, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Cody Daniel Bair, LCSWNPI 1538479738

Title

Owner/LCSW

Phone

(814) 380-4697

Specialties & licenses 1

Addresses

Other names 1

• CDB Therapy, LLC Other name

Practitioners 1

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.

• Cody Daniel Bair, LCSW

  • Clinical Social Worker
  • State College, PA
  • NPI 1538479738
  NPD (past) Authorized official

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

{
    "created_epoch": "1580428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580428800000",
    "number": "1225669955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 GRIZZLY LN",
            "city": "MADISONBURG",
            "state": "PA",
            "postal_code": "168528013",
            "telephone_number": "814-380-4697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 W COLLEGE AVE",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168012804",
            "telephone_number": "814-380-4697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CDB THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-31",
        "last_updated": "2020-01-31",
        "certification_date": "2020-01-31",
        "status": "A",
        "authorized_official_last_name": "BAIR",
        "authorized_official_first_name": "CODY",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER/LCSW",
        "authorized_official_telephone_number": "814-380-4697",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CDB Therapy, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Adolescent and Children Mental Health Clinic/Center in State College, PA
• Providers in State College, PA by specialty
• Adolescent and Children Mental Health Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2020; 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.