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MR. LARRY E SOUTHARD MA MFT NPI 1356304380


NPI Information

NPI: 1356304380
Provider Name: MR. LARRY E SOUTHARD, MA MFT
Classification: Marriage & Family Therapist - 106H00000X
Entity Type: Individual
Address:
1255 E HIGHLAND AVE
STE 105
SAN BERNARDINO, CA
ZIP 92404
Phone: (909) 881-5250
Get Directions

MR. Larry E Southard, MA MFT is a marriage family therapist in San Bernardino, CA. The provider is 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. MR. Larry E Southard, MA MFT NPI is 1356304380. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1255 E HIGHLAND AVE
STE 105
SAN BERNARDINO, CA
ZIP 92404
Phone: (909) 881-5250
Fax: (909) 337-2724

The enumeration date for this NPI number is 4/10/2006 and was last updated on 7/8/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1106H00000XMarriage & Family TherapistMFC18620CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1019346OTHERVMC BEHAVIORAL HEALTHCARE
2061147OTHERHEALTHNET
3MFT18620OTHERBLUE SHIELD OF CA
4065571OTHERMANAGED HEALTH NETWORK
556862099802OTHERPACIFICARE BEHAVIORAL HEA
66270815OTHERCALIFORNIAUS BEHAVIORAL HEALTH PLAN
7186380OTHERMAGELLAN BEHAVIORAL HEALT
8208994OTHERCIGNA BEHAVIORAL HEALTH
9386213OTHERVALUE OPTIONS
105362524OTHERAETNA BEHAVIORAL HEALTH P
1133B61DOTHERRIVERSIDE CNTY BEHAVIORAL
123112OTHERCONCERN EAP

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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