Travis, Richard L

Travis, Richard L is an individual health care provider with primary practice located at 1919 Ne 45Th Street #122, Fort Lauderdale FL 33308. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Travis, Richard L can be contacted via phone (954) 776-7176.

Contact Information

Primary practice address
1919 Ne 45Th Street #122 Fort Lauderdale FL 33308
Phone: (954) 776-7176
Fax: (954) 776-7160
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 042 Florida
Behavioral Health & Social Service Providers / Mental Health 101YM0800X MH2294 Florida

Profile Details

NPI number 1700996907
LBN Legal business name Travis, Richard L
Credentials EDD LMHC CAPP
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700996907 NPPES
Other Z4960 BCBS

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