Travis Booth LCPC, Inc.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

060.011815 Issued in IL

Legal business name

TRAVIS BOOTH LCPC, INC.

Practice address

1531 S Grove Ave Unit 204
Barrington, IL 60010-5251

Phone

(847) 381-2700

Fax

(847) 381-2722

NPI assigned

Jul 6, 2016

Organization subpart

No

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

Authorized official

Name

Travis Andrew Booth, MA, LCPC

Title

President

Phone

(847) 381-2700

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1467763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467763200000",
    "number": "1023460763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1531 S GROVE AVE UNIT 204",
            "city": "BARRINGTON",
            "state": "IL",
            "postal_code": "600105251",
            "telephone_number": "847-381-2700",
            "fax_number": "847-381-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1531 S GROVE AVE UNIT 204",
            "city": "BARRINGTON",
            "state": "IL",
            "postal_code": "600105251",
            "telephone_number": "847-381-2700",
            "fax_number": "847-381-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAVIS BOOTH LCPC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-06",
        "last_updated": "2016-07-06",
        "status": "A",
        "authorized_official_last_name": "BOOTH",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-381-2700",
        "authorized_official_credential": "MA, LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "060.011815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Barrington, IL
• Providers in Barrington, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2016; 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.