Active NPI
Brad Travis, MS.CADC
- Addiction (Substance Use Disorder) Counselor
- Joliet, IL
National Provider Identifier
1114202074
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 14173
- Practice address
- 1224 Norley Ave
Joliet, IL 60435-4074 - Phone
- (815) 690-0213
- Fax
- (815) 846-0436
- NPI assigned
- Oct 11, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 14173 | IL | Primary |
Addresses
Primary practice location
1224 Norley Ave
Joliet, IL 60435-4074
Mailing address
PO Box 153
Joliet, IL 60434-0153
Phone (815) 690-0213
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
| License | State | Type | Specialty |
|---|---|---|---|
| 14173 | IL | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318291200000",
"number": "1114202074",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 153",
"city": "JOLIET",
"state": "IL",
"postal_code": "604340153",
"telephone_number": "815-690-0213",
"fax_number": "815-846-0436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1224 NORLEY AVE",
"city": "JOLIET",
"state": "IL",
"postal_code": "604354074",
"telephone_number": "815-690-0213",
"fax_number": "815-846-0436"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAVIS",
"first_name": "BRAD",
"name_prefix": "Mr.",
"credential": "MS.CADC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-10-11",
"last_updated": "2011-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "IL",
"license": "14173",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Joliet, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.