Active NPI
Henry Monroe Childs III, MFT
- Marriage & Family Therapist
- San Francisco, CA
National Provider Identifier
1467753525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFT19953
- Practice address
- 204 Clement St
San Francisco, CA 94118-2408 - Phone
- (415) 573-2469
- NPI assigned
- Nov 5, 2010
- Last updated
- Mar 11, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFT19953 | CA | Primary |
Addresses
Primary practice location
204 Clement St
San Francisco, CA 94118-2408
Mailing address
204 Clement St
San Francisco, CA 94118-2408
Phone (415) 573-2469
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 5, 2024 through Mar 5, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFT19953 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710115200000",
"number": "1467753525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "204 CLEMENT ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941182408",
"telephone_number": "415-573-2469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "204 CLEMENT ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941182408",
"telephone_number": "415-573-2469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHILDS",
"first_name": "HENRY",
"middle_name": "MONROE",
"name_suffix": "III",
"credential": "MFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-11-05",
"last_updated": "2024-03-11",
"certification_date": "2024-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFT19953",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; 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.