Active NPI
Adrienne Clements, MFTI
- Mental Health Counselor
- Redondo Beach, CA
National Provider Identifier
1376095547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 86724
- Practice address
- 2312 Artesia Blvd
Redondo Beach, CA 90278-3142 - Phone
- (310) 465-6138
- NPI assigned
- Nov 3, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 86724 | CA | Primary |
Addresses
Primary practice location
2312 Artesia Blvd
Redondo Beach, CA 90278-3142
Mailing address
5371 E 28TH St
Long Beach, CA 90815-1002
Phone (818) 731-3502
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 1, 2024 through Mar 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 105630 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478131200000",
"number": "1376095547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5371 E 28TH ST",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908151002",
"telephone_number": "818-731-3502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2312 ARTESIA BLVD",
"city": "REDONDO BEACH",
"state": "CA",
"postal_code": "902783142",
"telephone_number": "310-465-6138"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLEMENTS",
"first_name": "ADRIENNE",
"credential": "MFTI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-11-03",
"last_updated": "2016-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "86724",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redondo Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.