Individual provider Active NPI

Christopher William Cusick, B.S.

  • Counselor
  • San Luis Obispo, CA
National Provider Identifier
1245303783
Registry record updated Feb 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
3793 Issued in CA
Practice address
2178 Johnson Ave
San Luis Obispo County Mental Health Services
San Luis Obispo, CA 93401-4535
Phone
(805) 541-5144
NPI assigned
Nov 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 3793 CA Primary

Addresses

Primary practice location

2178 Johnson Ave
San Luis Obispo County Mental Health Services
San Luis Obispo, CA 93401-4535

Mailing address

791 Price St
#135
Pismo Beach, CA 93449-2529
Phone (805) 305-5170

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
3793CAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235088000000",
    "number": "1245303783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "791 PRICE ST",
            "address_2": "#135",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934492529",
            "telephone_number": "805-305-5170",
            "fax_number": "805-805-5419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2178 JOHNSON AVE",
            "address_2": "SAN LUIS OBISPO COUNTY MENTAL HEALTH SERVICES",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014535",
            "telephone_number": "805-541-5144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSICK",
        "first_name": "CHRISTOPHER",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "B.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2009-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": "3793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2009; 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.