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CODY SPENCER BLACK RADT
NPI 1174377055
Counselor - Addiction (Substance Use Disorder) in San Pedro, CA

Active since April 16, 2024
132 W 10TH ST, SAN PEDRO, CA 90731(310) 514-4940 Get Directions Write a Review

NPPES record last updated: April 16, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Cody Spencer Black Radt NPPES

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

CODY SPENCER BLACK RADT (NPI 1174377055) is an individual addiction (substance use disorder) provider in San Pedro, California, licensed in California (R1557170424) and active in the NPI registry since April 2024.

NPPES Registry Identity

NPI1174377055
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameCODY SPENCER BLACKCredential: RADT
Location Address132 W 10TH STSan Pedro, CA 90731-3702
Mailing Address1003 S Beacon StSan Pedro, CA 90731-4324 · (310) 514-4940
Phone(310) 514-4940
Sole ProprietorNo
Enumeration DateApril 16, 2024
NPPES CertifiedApril 16, 2024
✔ NPI 1174377055 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in CA · R1557170424
132 W 10TH ST, San Pedro, CA 90731
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Other Providers at the Same Location NPPES 10

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

MARY SUSAN COOK
Counselor (Addiction (Substance Use Disorder))
132 W 10TH ST
SAN PEDRO, CA 90731
Los Angeles County (310) 514-4940
MR. BRYCE HART MOULTON 14303-RAC
Counselor (Addiction (Substance Use Disorder))
132 W 10TH ST
SAN PEDRO, CA 90731
Los Angeles County (310) 514-4940
ROBERT DAVIS
Counselor (Addiction (Substance Use Disorder))
132 W 10TH ST
SAN PEDRO, CA 90731
Los Angeles County (310) 514-4940
ANDREW WILLIAM BOLAN RADT
Counselor (Addiction (Substance Use Disorder))
132 W 10TH ST
SAN PEDRO, CA 90731
Los Angeles County (310) 514-4940
RANDY HOLSOPPLE CATC
Counselor (Addiction (Substance Use Disorder))
132 W 10TH ST
SAN PEDRO, CA 90731
Los Angeles County (310) 514-4940
THE BEACON HOUSE ASSOCIATION OF SAN PEDRO
Substance Abuse Rehabilitation Facility
132 W 10TH ST
SAN PEDRO, CA 90731
Los Angeles County (310) 514-4940
SLOANE K SMITH SUDRC #12356
Counselor (Addiction (Substance Use Disorder))
132 W 10TH ST
SAN PEDRO, CA 90731
Los Angeles County (310) 872-5939
VAUGHNDRELL LANCE WATKINS RADT
Counselor (Addiction (Substance Use Disorder))
132 W 10TH ST
SAN PEDRO, CA 90731
Los Angeles County (310) 514-4940

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 Cody Black's NPI number?

The NPI number for Cody Black is 1174377055. It was assigned to this individual provider in the NPPES registry on April 16, 2024.

Where is Cody Black located?

Cody Black practices at 132 W 10th St, San Pedro, CA 90731. The listed phone number is (310) 514-4940.

What is Cody Black's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Cody Black was last updated on April 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.