Travis T Mord

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP7230 Issued in MN

Practice address

10567 165TH St W Ste B
Lakeville, MN 55044-3525

Phone

(952) 767-9374

NPI assigned

Sep 15, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Clinical Psychologist

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mears Psychological LLCGroup PAC ID 3971971284, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mears Psychological LLC

  • Clinical Psychologist
  • Lakeville, MN
  • NPI 1881333946
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1600128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1285249391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W175N11120 STONEWOOD DR",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530224799",
            "telephone_number": "800-438-1772",
            "fax_number": "262-345-5562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10567 165TH ST W STE B",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550443525",
            "telephone_number": "952-767-9374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORD",
        "first_name": "TRAVIS",
        "middle_name": "T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-15",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP7230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fartun Tahlil Mohamud
• Susan M Monnens, LCMT
• Connor Hang Monorom, REGISTERED NURSE
• Ashley M Montgomery
• Abgail G Mord
• Stefanie Moreno, CMT
• Sarah Morgan
• Hailey Jo Mork
• Datassa O Morrissey, LAT, ATC
• Denae Moryn

• Clinical Psychologist in Lakeville, MN
• Providers in Lakeville, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.