Individual provider Active NPI

Melody Loren Black, LMFT

  • Marriage & Family Therapist
  • Westlake Village, CA
National Provider Identifier
1649332958
Registry record updated Aug 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
45646 Issued in CA
Practice address
875 S Westlake Blvd Ste 211
Westlake Village, CA 91361-2925
Phone
(805) 449-4375
NPI assigned
Dec 14, 2006
Last updated
Aug 13, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 45646 CA Primary

Addresses

Primary practice location

875 S Westlake Blvd Ste 211
Westlake Village, CA 91361-2925

Mailing address

933 Westcreek LN Apt 218
Westlake Village, CA 91362-5450
Phone (805) 338-1277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
45646CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281657600000",
    "number": "1649332958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 WESTCREEK LN APT 218",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913625450",
            "telephone_number": "805-338-1277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 S WESTLAKE BLVD STE 211",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913612925",
            "telephone_number": "805-449-4375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "MELODY",
        "middle_name": "LOREN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2010-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "45646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake Village, CA

Sources for this page

Verify at the official NPI Registry.