Travis Childress

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

4101006829 Issued in MI

Practice address

6530 Secor Rd Ste 10
Lambertville, MI 48144-9456

Phone

(734) 854-7061

NPI assigned

Jan 21, 2019

Last updated

Jan 21, 2019By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Christian Care Connection LLC

  • Mental Health Counselor
  • Lambertville, MI
  • NPI 1205983038
  NPD (past)

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

{
    "created_epoch": "1548028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548028800000",
    "number": "1326512658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 RENFREW AVE",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492211807",
            "telephone_number": "417-588-0977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6530 SECOR RD STE 10",
            "city": "LAMBERTVILLE",
            "state": "MI",
            "postal_code": "481449456",
            "telephone_number": "734-854-7061"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6530 Secor Rd Ste 10",
            "address_purpose": "LOCATION",
            "city": "Lambertville",
            "state": "MI",
            "postal_code": "481449456",
            "country_code": "US",
            "telephone_number": "734-854-7061",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHILDRESS",
        "first_name": "TRAVIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-21",
        "last_updated": "2019-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MI",
            "license": "4101006829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomasene Byers, C.R.N.A.
• Lisa Calcamuggio, LISA CALCAMUGGIO
• Thomas Joseph Calloway, RPH
• Eric Alan Carter, RPH
• Keith Richard Cherry, MSW
• Kelly Nicole Chisholm, CNP
• Christian Care Connection LLC
• Citadel Health Equipment Corp.
• Andrew Leon Clark
• Tracy Collum

• Marriage & Family Therapist in Lambertville, MI
• Providers in Lambertville, MI by specialty
• Marriage & Family Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2019; 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.