MR. TRAVIS DALE SMITH (NPI# 1245864958) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245864958 |
| Entity Type | Individual |
| Full Name | MR. TRAVIS DALE SMITH |
| Credential | LPC |
| Practice Address |
2255 W Northern Ave Phoenix AZ 85021-4936 |
| Practice Telephone | 6029951767 |
| Practice Fax Number | 6029951863 |
| Mailing Telephone | 6029951767 |
| Mailing Fax Number | 6029951863 |
| Enumeration Date | 2020-03-03 |
| Last Update Date | 2020-03-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
LPC-18444 | AZ | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467931287 | Travis Dean Smith | Contractor | 443 Grover Ln, Jamestown, TN 38556-5568 | 2018-08-13 |
| 1821591314 | Travis Smith | Hearing Instrument Specialist | 1950 Deyerle Ave Ste A, Harrisonburg, VA 22801-5423 | 2018-03-12 |
| 1487104139 | Travis Smith | Specialist/Technologist | 313 S 11th St, Bismarck, ND 58504-5621 | 2016-10-06 |
| 1538599006 | Travis Mark Smith | Social Worker | 1800 W Big Beaver Rd Ste 150, Troy, MI 48084-3535 | 2013-11-20 |
| 1477184869 | Travis Charles Smith | Physical Therapy Assistant | 420 Jett Dr, Jackson, KY 41339-9621 | 2020-02-04 |
| 1497222533 | Travis L Smith | Case Manager/Care Coordinator | 220 S Main St, Kendallville, IN 46755-1718 | 2018-10-26 |
| 1629544481 | Travis Nathan Smith | Massage Therapist | 216 E Chatham St Ste 110, Cary, NC 27511-3495 | 2018-10-19 |
| 1174015408 | Travis John Smith | Student in an Organized Health Care Education/Training Program | 500 University Dr, Hershey, PA 17033-2360 | 2018-06-01 |
| 1336501675 | Travis Smith | Student in an Organized Health Care Education/Training Program | 47 New Scotland Ave, Dept. of Neurology, Albany, NY 12208-3412 | 2016-03-25 |
| 1447620372 | Travis Smith | Counselor | 78 Centennial Loop Ste A, Eugene, OR 97401-7900 | 2015-10-05 |
| Street Address |
2255 W NORTHERN AVE |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85021-4936 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881680452 | Psa Behavioral Health Agency | Public Health or Welfare | 2255 W Northern Ave, Suite B-100, Phoenix, AZ 85021-4936 | 2005-09-20 |
| 1235774480 | Aaron Hiller | Nurse Practitioner | 2255 W Northern Ave, Phoenix, AZ 85021-4936 | 2019-11-12 |
| 1811401573 | Marlene Reed | Counselor | 2255 W Northern Ave, Phoenix, AZ 85021-4936 | 2017-11-16 |
| 1912342924 | Blythe A Fitzharris | Social Worker | 2255 W Northern Ave, Suite B100, Phoenix, AZ 85021-4936 | 2013-05-03 |
| 1588937643 | Joan Elizabeth Grussing | Counselor | 2255 W Northern Ave, Suite B100, Phoenix, AZ 85021-4936 | 2012-02-20 |
| 1568640332 | Belinda R Rouzaud | Social Worker | 2255 W Northern Ave, B-103, Phoenix, AZ 85021-4936 | 2008-02-04 |
| 1861459745 | Robert J. Henley | Psychologist | 2255 W Northern Ave, Suite B-111, Phoenix, AZ 85021-4936 | 2006-04-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679173181 | Jill M Robinson | Social Worker | 8804 N. 23rd Ave, Bldg. A Ste. A01-a02, Phoenix, AZ 85021 | 2020-10-26 |
| 1528671013 | Sabrina Mcninch | Behavior Technician | 1200 W Dunlap Ave, Ste 100, Phoenix, AZ 85021 | 2020-08-25 |
| 1376169938 | Maricopa County Special Heallth Care District | Pharmacy | 2025 W Northern Ave, Phoenix, AZ 85021 | 2020-06-19 |
| 1841832664 | Madison Westby | Physical Therapist | 717 W Dunlap Ave # 100, Phoenix, AZ 85021 | 2019-10-14 |
| 1861967481 | Southwest Family Naturopathic Clinic Pllc | Naturopath | 1530 W Glendale Ave Suite 103, Phoenix, AZ 85021 | 2018-10-10 |
| 1184101461 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 8804 N 23rd Ave, Suite A01/a02, Phoenix, AZ 85021 | 2018-07-19 |
| 1568970150 | Alycia Ann Poloni | Occupational Therapist | 7129 N 23d Ave, Phoenix, AZ 85021 | 2018-01-17 |
| 1154839165 | Cyrus Professional Corporation | Dentist | 2401 W. Glendale Ave, Ste 102, Phoenix, AZ 85021 | 2018-01-12 |
| 1568980779 | Marla Jean Clay | Licensed Practical Nurse | 1717 W. Glendale Ave. Apt. 3011, Phoenix, AZ 85021 | 2017-09-07 |
| 1801325162 | Kaitlin King | Nurse Practitioner | 8824 N 9th Ave, Phoenix, AZ 85021 | 2017-06-08 |
| Find all providers in zip 85021 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417557729 | Psychological and Consulting Services LLC | Counselor | 331 N 1st Ave Ste 102, Phoenix, AZ 85003-4528 | 2020-10-27 |
| 1447863683 | Mindscape Wellness LLC | Counselor | 4545 N 36th St Ste 117, Phoenix, AZ 85018-3473 | 2020-08-27 |
| 1700496718 | Suma Hodge | Counselor | 2341 N 83rd Dr, Phoenix, AZ 85037-3742 | 2020-08-04 |
| 1992322127 | North Pointe Services | Counselor | 1807 W Sienna Bouquet Pl, Phoenix, AZ 85085-8042 | 2020-07-03 |
| 1023630308 | Mary Squires Moran | Counselor | 14040 N Cave Creek Rd Ste 205, Phoenix, AZ 85022-6179 | 2020-05-10 |
| 1467087106 | Omnipotent Health Services | Counselor | 3442 W Paradise Dr, Phoenix, AZ 85029-2239 | 2020-03-03 |
| 1124650536 | Erica Van Parys | Counselor | 3207 E Medlock Dr, Phoenix, AZ 85018-1426 | 2020-02-05 |
| 1790324556 | Amy Kathleen Engle | Counselor | 2432 W Peoria Ave Ste 1123, Phoenix, AZ 85029-4733 | 2019-12-26 |
| 1851934012 | Extinguishing Fear Life Coaching | Counselor | 4435 E Chandler Blvd, Phoenix, AZ 85048-7649 | 2019-10-21 |
| 1134761661 | Kerry Jean Ramella | Counselor | 809 W Maryland Ave, Phoenix, AZ 85013-1325 | 2019-10-16 |
| Find all providers in PHOENIX | ||||
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| 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.