Clyde Amel Blair III, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC47961 Issued in CA

Practice address

721 E Main St
Ventura, CA 93001-2905

Phone

(805) 302-8474

NPI assigned

Jun 25, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1277424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467244800000",
    "number": "1841501640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1723 GARDEN ST",
            "address_2": "APT. 6",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931011071",
            "telephone_number": "805-302-8474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 E MAIN ST",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930012905",
            "telephone_number": "805-302-8474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "CLYDE",
        "middle_name": "AMEL",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-25",
        "last_updated": "2016-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC47961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Tanneke Bisbee
• Christina Kay Bjornstedt, MFT
• Brina Rylie Blackman
• Debra Gail Blackwell-Schrag, MS, LMFT
• Lynne Blackwell, NP-C
• Shana Danbi Blair
• Brenn Ashton Blaisdell
• Debbie Lynn Blaney
• Blayne Robinson Liparoto
• Allison Blaze, M.D.

• Marriage & Family Therapist in Ventura, CA
• Providers in Ventura, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.