Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Cody Spencer Black, RADT

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1174377055

Cody Spencer Black, RADT is an Addiction (Substance Use Disorder) Counselor in San Pedro, California. Licensed in California. Registered with an NPI since 2024.

Licensed in
CA
In the registry since
2024

Practice location Address checks out

132 W 10th St
San Pedro, CA 90731-3702
Phone: (310) 514-4940
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence R1557170424 (CA)

Record details

NPI number1174377055
Entity typeIndividual (Type 1)
GenderMale
Credentials RADT
Sole proprietorNo
NPI enumeratedApril 16, 2024
Last updated in NPPESApril 16, 2024
Certification dateApril 16, 2024

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