Individual provider · Type 1 NPI

Cody Spencer Black, RADT

Addiction (Substance Use Disorder) Counselor · San Pedro, CA

NPI number 1174377055 Active

Practice location

132 W 10th St
San Pedro, CA 90731-3702

Call (310) 514-4940 Map

Mailing address

1003 S Beacon St
San Pedro, CA 90731-4324

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XR1557170424 (CA)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1174377055

Cody Spencer Black, RADT's National Provider Identifier is 1174377055, issued on Apr 16, 2024. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in San Pedro, CA. The record was last updated on Apr 16, 2024.