Black Granola

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

BLACK GRANOLA

Practice address

1955 Menalto Ave
Menlo Park, CA 94025-2834

Phone

(650) 422-0340

NPI assigned

Jun 8, 2022

Organization subpart

No

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

Authorized official

Name

Nehezi Roberts, LCSWNPI 1184271942

Title

Founder

Phone

(650) 422-0340

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nehezi Roberts

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1184271942
  NPD Authorized official

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

{
    "created_epoch": "1654646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654646400000",
    "number": "1487383188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "896 GREEN ST",
            "city": "EAST PALO ALTO",
            "state": "CA",
            "postal_code": "943031947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 MENALTO AVE",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940252834",
            "telephone_number": "650-422-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK GRANOLA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-08",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "NEHEZI",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "650-422-0340",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emilia Bieganowska
• Billiontoone Inc
• Sandra Birdwell, MD
• Celeste Phaneuf Birkhofer, MFT, PHD
• Julia Birt, PSYD
• Stewart Blain, PSY.D.
• Christine Chang Blake, PH.D.
• Maggie Christine Blake, DPT
• Blanca Sana
• Katherine Elliott Blank, OTR/L

• Clinical Social Worker in Menlo Park, CA
• Providers in Menlo Park, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; 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.