TRAVIS GORDON (NPI# 1104488105) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104488105 |
| Entity Type | Individual |
| Full Name | TRAVIS GORDON |
| Practice Address |
800 Monroe Ave Nw Ste 319 Grand Rapids MI 49503-1451 |
| Mailing Address |
1001 E Beltline Ave Ne Grand Rapids MI 49525-5803 |
| Practice Telephone | 6162754646 |
| Enumeration Date | 2019-07-01 |
| Last Update Date | 2019-07-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477072114 | Travis Gordon | Behavioral Analyst | 3003 Northup Way Ste 200, Bellevue, WA 98004-1480 | 2017-09-13 |
| 1285069393 | Travis Gordon | Family Medicine | 7975 Lake Underhill Rd, Suite 210, Orlando, FL 32822-8202 | 2013-09-08 |
| Street Address |
800 MONROE AVE NW STE 319 |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49503-1451 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871192120 | Katelyn Wysocki | Counselor | 800 Monroe Ave Nw Ste 319, Grand Rapids, MI 49503-1451 | 2020-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801496195 | Airway Oxygen, Inc. | Durable Medical Equipment & Medical Supplies | Lemmen Holton Cancer Pavilion, 145 Michigan St Ne Ste 3400, Grand Rapids, MI 49503 | 2020-10-27 |
| 1730707282 | Adriana Molina-schmuker | Counselor | 901 Eastern Avenue Ne, Grand Rapids, MI 49503 | 2020-07-10 |
| 1477176949 | Kimberly Buskirk | Specialist | 1131 Ionia Ava Nw, Grand Rapids, MI 49503 | 2020-05-19 |
| 1124647805 | Jared Host | Speech-Language Pathologist | Mercy Health Hauenstein Neuroscience Center 220 Cherry, Grand Rapids, MI 49503 | 2020-04-13 |
| 1265061378 | Heather Gladfelter | Student in an Organized Health Care Education/Training Program | 339 Barclay Ave Ne Ste 300, Grand Rapids, MI 49503 | 2020-04-02 |
| 1194368647 | Amy Jo Arends | Nurse Practitioner | 350 Lafayette S.e., Suite 301, Grand Rapids, MI 49503 | 2019-10-28 |
| 1376185199 | Beth Arce | Occupational Therapist | 245 Cherry St Se Suite 302, Grand Rapids, MI 49503 | 2019-10-14 |
| 1295387256 | Althea Ziolkowski | Licensed Practical Nurse | Salvation Army Turning Point Programs, 1215 Fulton St E, Grand Rapids, MI 49503 | 2019-07-10 |
| 1790340719 | Heather Anne Fox | Occupational Therapist | Marywood, 111 Lakeside Dr Ne, Grand Rapids, MI 49503 | 2019-05-06 |
| 1184182883 | April L Kaiserlian | Social Worker | 983 Spaulding Ave Ne, Ada, MI 49503 | 2019-03-12 |
| Find all providers in zip 49503 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164020558 | Danita Mcalister | Counselor | 2504 Normandy Dr Se Apt 213b, Grand Rapids, MI 49506-7901 | 2020-10-16 |
| 1013521574 | Megan Flier | Counselor | 3744 Bradford St Ne, Grand Rapids, MI 49525-3325 | 2020-09-02 |
| 1457962078 | Cappon Consulting LLC | Counselor | 1344 Mayfield Ave Ne, Grand Rapids, MI 49505-5525 | 2020-08-17 |
| 1124644596 | Travis James Atkinson | Counselor | 3000 Wausaukee Dr Ne, Grand Rapids, MI 49525-1916 | 2020-06-22 |
| 1639790207 | Tracey Wicks | Counselor | 78 Centerbrook St Se, Grand Rapids, MI 49548-6902 | 2020-05-05 |
| 1174160592 | Lindsey Elizabeth Rosa | Counselor | 845 5th St Nw Apt 2, Grand Rapids, MI 49504-5163 | 2019-12-04 |
| 1710530597 | New Way Counseling LLC | Counselor | 1971 E Beltline Ave Ne Ste C, Grand Rapids, MI 49525-7045 | 2019-07-19 |
| 1588216048 | Kate Jack | Counselor | 3351 Claystone St Se Ste G32, Grand Rapids, MI 49546-5794 | 2019-07-15 |
| 1255996575 | The Family Therapy Place Pllc | Counselor | 731 Front Ave Nw, Grand Rapids, MI 49504-5366 | 2019-05-02 |
| 1063075562 | Kelly Lynn Ibarra | Counselor | 4467 Cascade Road Se, Suite #4479, Grand Rapids, MI 49546 | 2019-04-19 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49503 |
Please comment or provide details below to improve the information on TRAVIS GORDON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.