Individual provider Active NPI

Travis M Morrison, LCSW, LCADC

  • Clinical Social Worker
  • Owensboro, KY
National Provider Identifier
1033467006
Registry record updated May 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
252396 Issued in KY
Practice address
121 E 2ND St
Ste 401
Owensboro, KY 42303-4109
Phone
(270) 315-1226
Fax
(270) 240-1224
NPI assigned
Aug 26, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 166043 KY
Clinical Social Worker 1041C0700X 252396 KY Primary

Addresses

Primary practice location

121 E 2ND St
Ste 401
Owensboro, KY 42303-4109

Mailing address

121 E 2ND St
Ste 401
Owensboro, KY 42303-4109
Phone (270) 315-1226

Other practice location 1

1100 Walnut St
Owensboro, KY 42301-2956
Phone (270) 689-6500

Other identifiers 1

IdentifierTypeStateIssuer
7100412480MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161228002133 KY Practitioner - Clinical Social Worker 7911288238 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
166043KYMDMental Health Counselor
252396KYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Truenorth Treatment Center, LLC Mental Health CurrentSince Apr 1, 2019 Accepting new patients

Locations

121 E 2nd St
Ste 401
Owensboro, KY 42303
Phone (270) 240-1785

1100 Walnut St
Owensboro, KY 42301
Phone (270) 689-6500

Organizations & group practices 1

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": "1345939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557360000000",
    "number": "1033467006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 E 2ND ST",
            "address_2": "STE 401",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423034109",
            "telephone_number": "270-315-1226",
            "fax_number": "270-315-1226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 E 2ND ST",
            "address_2": "STE 401",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423034109",
            "telephone_number": "270-315-1226",
            "fax_number": "270-240-1224"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Walnut St",
            "address_purpose": "LOCATION",
            "city": "Owensboro",
            "state": "KY",
            "postal_code": "423012956",
            "country_code": "US",
            "telephone_number": "270-689-6500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORRISON",
        "first_name": "TRAVIS",
        "middle_name": "M",
        "credential": "LCSW, LCADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-26",
        "last_updated": "2019-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "166043",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "252396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100412480",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

Verify at the official NPI Registry.