Individual provider Active NPI

Scott Kristopher Blackburn, LMFT

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1992955710
Registry record updated Sep 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 50890 Issued in CA
Practice address
3580 Wilshire Blvd
8TH Floor
Los Angeles, CA 90010-2501
Phone
(213) 637-5000
Fax
(213) 427-2100
NPI assigned
Sep 29, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2012

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 MFC 50890 CA Primary

Addresses

Primary practice location

3580 Wilshire Blvd
8TH Floor
Los Angeles, CA 90010-2501

Mailing address

3580 Wilshire Blvd
8TH Floor
Los Angeles, CA 90010-2501
Phone (213) 637-5000

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

LicenseStateTypeSpecialty
MFC 50890CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1222646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348012800000",
    "number": "1992955710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3580 WILSHIRE BLVD",
            "address_2": "8TH FLOOR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900102501",
            "telephone_number": "213-637-5000",
            "fax_number": "213-427-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3580 WILSHIRE BLVD",
            "address_2": "8TH FLOOR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900102501",
            "telephone_number": "213-637-5000",
            "fax_number": "213-427-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "SCOTT",
        "middle_name": "KRISTOPHER",
        "name_prefix": "Mr.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-29",
        "last_updated": "2012-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 50890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2012; 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.