Anthony Keith Travis, LLMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801103276 Issued in MI

Practice address

1206 Clinton Rd
Jackson, MI 49202-2005

Phone

(517) 783-4250

NPI assigned

Oct 21, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Catholic Charities of Jackson, Lenawee and Hillsdale Counties

  • Community/Behavioral Health Agency
  • Jackson, MI
  • NPI 1689628190
  NPD

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

{
    "created_epoch": "1571616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1023651270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 CLINTON RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022005",
            "telephone_number": "517-783-4250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 CLINTON RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022005",
            "telephone_number": "517-783-4250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3425 Francis St",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MI",
            "postal_code": "492035052",
            "country_code": "US",
            "telephone_number": "269-719-0574",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAVIS",
        "first_name": "ANTHONY",
        "middle_name": "KEITH",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-21",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801103276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adam James Traud, CRNA
• Kassidy Jo Treacey
• Deanna Marie Tregoning, ARNP
• David Trevisan, MSOP, CO
• Trimas Family Care PLLC
• Eric T Trimas, DO

• Clinical Social Worker in Jackson, MI
• Providers in Jackson, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2021; 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.