Organization Active NPI

Traviss Family Counseling

  • Clinical Social Worker
  • Santa Rosa, CA
National Provider Identifier
1215087697
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS4035 & LCS5260 Issued in CA
Legal business name
TRAVISS FAMILY COUNSELING
Practice address
2455 Bennett Valley Rd
Suite 208B
Santa Rosa, CA 95404-5663
Phone
(707) 526-2595
Fax
(707) 539-6809
NPI assigned
Jan 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Patrick A Traviss, LCSW
Title
President
Phone
(707) 526-2595

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X LCS4035 & LCS5260 CA Primary

Addresses

Primary practice location

2455 Bennett Valley Rd
Suite 208B
Santa Rosa, CA 95404-5663

Mailing address

1825 San Ramon Way
Santa Rosa, CA 95409-3967
Phone (707) 526-2595

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215087697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 SAN RAMON WAY",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954093967",
            "telephone_number": "707-526-2595",
            "fax_number": "707-539-6809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2455 BENNETT VALLEY RD",
            "address_2": "SUITE 208B",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954045663",
            "telephone_number": "707-526-2595",
            "fax_number": "707-539-6809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAVISS FAMILY COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TRAVISS",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-526-2595",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS4035 & LCS5260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.