Travis Fragale, LPC

Individual provider Active NPI Professional Counselor · Atlantic Highlands, NJ

NPI 1306405121 · NPPES record last updated Sep 3, 2024

Key facts

NPI
1306405121
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
37PC00946500 (NJ)
Practice address
52 Avenue C
Atlantic Highlands, NJ 07716-1134
Phone
(732) 337-3326
NPI assigned
Jun 6, 2019
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
37PC00946500NJMDProfessional Counselor

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.travisfragale@148376.advancedmd-direct.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 37PC00946500 NJ Yes

Addresses

Primary practice location

52 Avenue C
Atlantic Highlands, NJ 07716-1134

Mailing address

52 Avenue C
Atlantic Highlands, NJ 07716-1134

Other providers in Atlantic Highlands, NJ

All providers in Atlantic Highlands, NJ · Professional Counselor in New Jersey

Sources for this page

Verify at the official NPI Registry.