Active NPI
Brenda Larue Nichols, MFT INTERN
- Mental Health Counselor
- Torrance, CA
National Provider Identifier
1679609960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 58785
- Practice address
- 4025 W 226TH St
Torrance, CA 90505-2340 - Phone
- (310) 373-4556
- Fax
- (310) 373-4096
- NPI assigned
- Feb 23, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 58785 | CA | Primary |
Addresses
Primary practice location
4025 W 226TH St
Torrance, CA 90505-2340
Mailing address
13107 S Saint Andrews PL
Gardena, CA 90249-1831
Phone (310) 400-3009
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
| License | State | Type | Specialty |
|---|---|---|---|
| 58785 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1298332800000",
"number": "1679609960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13107 S SAINT ANDREWS PL",
"city": "GARDENA",
"state": "CA",
"postal_code": "902491831",
"telephone_number": "310-400-3009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4025 W 226TH ST",
"city": "TORRANCE",
"state": "CA",
"postal_code": "905052340",
"telephone_number": "310-373-4556",
"fax_number": "310-373-4096"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLS",
"first_name": "BRENDA",
"middle_name": "LARUE",
"name_prefix": "Ms.",
"credential": "MFT INTERN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-23",
"last_updated": "2011-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "58785",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Torrance, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.