Active NPI
Aundrea Mishon Travis
- Mental Health Counselor
- Fredericksburg, VA
National Provider Identifier
1114668845
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 0704014121
- Practice address
- 4533 Alliance Way
Fredericksburg, VA 22408-3915 - Phone
- (703) 899-1325
- NPI assigned
- Apr 5, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 0704014121 | VA | Primary |
Addresses
Primary practice location
4533 Alliance Way
Fredericksburg, VA 22408-3915
Mailing address
4533 Alliance Way
Fredericksburg, VA 22408-3915
Phone (703) 899-1325
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 |
|---|---|---|---|
| 0704014121 | VA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649116800000",
"number": "1114668845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4533 ALLIANCE WAY",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "224083915",
"telephone_number": "703-899-1325"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4533 ALLIANCE WAY",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "224083915",
"telephone_number": "703-899-1325"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAVIS",
"first_name": "AUNDREA",
"middle_name": "MISHON",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-05",
"last_updated": "2022-04-05",
"certification_date": "2022-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "VA",
"license": "0704014121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fredericksburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.