Todd Black Licensed Marriage and Family Therapist PC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

TODD BLACK LICENSED MARRIAGE AND FAMILY THERAPIST PC

Practice address

120 N El Camino Real
San Mateo, CA 94401-2791

Phone

(650) 260-8564

NPI assigned

Aug 28, 2020

Last updated

Aug 28, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Todd C Black, LMFTNPI 1194271155

Title

President

Phone

(650) 260-8564

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Todd Black

  • Mental Health Counselor
  • San Carlos, CA
  • NPI 1194271155
  NPD Authorized official

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

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598572800000",
    "number": "1528671674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 N EL CAMINO REAL",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944012791",
            "telephone_number": "650-260-8564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 N EL CAMINO REAL",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944012791",
            "telephone_number": "650-260-8564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TODD BLACK LICENSED MARRIAGE AND FAMILY THERAPIST PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-28",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-27",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "650-260-8564",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.toddblack@toddblacklmft.com",
            "affiliation": "N",
            "endpointDescription": "secure email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "120 N El Camino Real",
            "city": "San Mateo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "944012791",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in San Mateo, CA
• Providers in San Mateo, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2020; 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.