Individual provider Active NPI

Chanel Treadwell, LPCC, PPS

  • Mental Health Counselor
  • Loma Linda, CA
National Provider Identifier
1477115111
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
13284 Issued in CA
Practice address
PO Box 1416
Loma Linda, CA 92354-1416
Phone
(909) 334-1903
NPI assigned
Jul 2, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 13284 CA Primary

Addresses

Primary practice location

PO Box 1416
Loma Linda, CA 92354-1416

Mailing address

PO Box 1416
Loma Linda, CA 92354-1416
Phone (909) 334-1903

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hello@serenityinbloomtherapy.com

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

State licenses

LicenseStateTypeSpecialty
13284CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clay Counseling Foundation PastSince Jan 1, 2025 Accepting new patients
Clay Counseling Solutions, Inc. PastSince Oct 6, 2019 Accepting new patients
Clay Counseling & Family Therapy, Professional Corporation PastSince Aug 25, 2025 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1477115111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1416",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923541416",
            "telephone_number": "909-334-1903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 1416",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923541416",
            "telephone_number": "909-334-1903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREADWELL",
        "first_name": "CHANEL",
        "credential": "LPCC, PPS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-02",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "13284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hello@serenityinbloomtherapy.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "address_1": "PO Box 1416",
            "city": "Loma Linda",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923541416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2025; 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.