Individual provider Active NPI

Travis B Guerrero, LMSW

  • Clinical Social Worker
  • Kalamazoo, MI
National Provider Identifier
1003371907
Registry record updated Jan 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801117328 Issued in MI
Practice address
6120 Stadium Dr Ste 100
Kalamazoo, MI 49009-3022
Phone
(269) 245-9455
NPI assigned
Feb 5, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801117328 MI Primary

Addresses

Primary practice location

6120 Stadium Dr Ste 100
Kalamazoo, MI 49009-3022

Mailing address

8415 Shirley CT Apt 11
Portage, MI 49024-4764
Phone (269) 245-9455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6801117328MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Luminous Path Therapy CurrentSince May 19, 2024 Accepting new patients
Kelsea a Howell PLLC Clinical Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1549324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704585600000",
    "number": "1003371907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8415 SHIRLEY CT APT 11",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244764",
            "telephone_number": "269-245-9455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6120 STADIUM DR STE 100",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490093022",
            "telephone_number": "269-245-9455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRERO",
        "first_name": "TRAVIS",
        "middle_name": "B",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-05",
        "last_updated": "2024-01-07",
        "certification_date": "2024-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801117328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.