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CAMILLE BLACK
NPI 1083137467
Marriage & Family Therapist in Camarillo, CA

Active since July 18, 2017PECOS Enrolled
5284 ADOLFO RD, CAMARILLO, CA 93012(805) 289-0120 Get Directions Write a Review

NPPES record last updated: April 18, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 18, 2022, Jul 18, 2017 (2 updates tracked since 2017).

About Camille Black NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CAMILLE BLACK (NPI 1083137467) is an individual marriage & family therapist in Camarillo, California, licensed in California (127823) and active in the NPI registry since July 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1083137467
Entity TypeIndividualFemale
Primary Taxonomy106H00000X
Provider Legal NameCAMILLE BLACK
Location Address5284 ADOLFO RDCamarillo, CA 93012-6787
Mailing AddressPo Box 19153Newbury Park, CA 91319-9153 · (805) 795-0987
Phone(805) 289-0120
Sole ProprietorNo
Enumeration DateJuly 18, 2017
Last NPPES UpdateApril 18, 20222 updates tracked since enumeration
NPPES CertifiedApril 18, 2022
✔ NPI 1083137467 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
Licenses✔ Licensed in CA · 127823✔ Licensed in CA · 97114
Definition
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.
5284 ADOLFO RD, Camarillo, CA 93012
Open in Google Maps ↗

Other Identifiers 1

Other56CCCA · Aspiranet

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Camille Black is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Camille Black reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Southern California Permanente Medical Group
8.8 mi
Health Maintenance Organization
2103 E GONZALES RD
Oxnard, CA 93036
  • Reassigned Medicare billing, California enrollment
  • 13,921 clinicians in this Medicare group
NPI 1275756652 (805) 650-4700
Engage You, Inc
10 mi
Psychologist
650 HAMPSHIRE RD STE 104
Westlake Village, CA 91361
  • Reassigned Medicare billing, California enrollment
  • 3 clinicians in this Medicare group
NPI 1558101568 (805) 601-6700

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MIREYA NORIS
Social Worker
5284 ADOLFO RD
CAMARILLO, CA 93012
Ventura County (805) 289-0120
DANTE FEW
Counselor (Mental Health)
5284 ADOLFO RD
CAMARILLO, CA 93012
Ventura County (805) 289-0120
TRISHA DAVIS
Counselor (Mental Health)
5284 ADOLFO RD
CAMARILLO, CA 93012
Ventura County (805) 289-0120
IRENE MARIE DOMINGUEZ
Counselor (Mental Health)
5284 ADOLFO RD
CAMARILLO, CA 93012
Ventura County (805) 289-0120
NICOLE MARIE LOWE
Counselor (Mental Health)
5284 ADOLFO RD
CAMARILLO, CA 93012
Ventura County (805) 330-7875
ELIZABETH PINKEL MFT INTERN
Counselor (Mental Health)
5284 ADOLFO RD
CAMARILLO, CA 93012
Ventura County (805) 289-0120
CORAIMA ENRIQUEZ
Social Worker (Clinical)
5284 ADOLFO RD
CAMARILLO, CA 93012
Ventura County (805) 289-0120
MS. GINA ARCHIE M.A.
Counselor (Mental Health)
5284 ADOLFO RD, SUITE 100
CAMARILLO, CA 93012
Ventura County (805) 289-0120

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Camille Black's NPI number?

The NPI number for Camille Black is 1083137467. It was assigned to this individual provider in the NPPES registry on July 18, 2017.

Where is Camille Black located?

Camille Black practices at 5284 Adolfo Rd, Camarillo, CA 93012. The listed phone number is (805) 289-0120.

What is Camille Black's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Is Camille Black enrolled in Medicare?

Yes. Camille Black is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Camille Black's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Camille Black reassigns Medicare benefits to 2 organizations: Southern California Permanente Medical Group (Oxnard, CA) and Engage You, Inc (Westlake Village, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Camille Black's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Camille Black was last updated on April 18, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.