Travis Nathan Tennant, LLMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6851118402 Issued in MI

Practice address

5900 Portage Rd Ste a
Portage, MI 49002-1774

Phone

(269) 319-3110

Fax

(269) 319-3110

NPI assigned

Apr 22, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1745280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1215724463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1933 SOUTHERN AVE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490014534",
            "telephone_number": "269-348-2579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 PORTAGE RD STE A",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490021774",
            "telephone_number": "269-319-3110",
            "fax_number": "269-319-3110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9594 N 40th St",
            "address_purpose": "LOCATION",
            "city": "Hickory Corners",
            "state": "MI",
            "postal_code": "490609327",
            "country_code": "US",
            "telephone_number": "269-548-3800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TENNANT",
        "first_name": "TRAVIS",
        "middle_name": "NATHAN",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-22",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "MI",
            "license": "6851118402",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851118402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Portage, MI
• Providers in Portage, 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 Nov 3, 2025; 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.