Travis Edward Williams, LCMHC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

12758 Issued in NC

Practice address

4208 Six Forks Rd Ste 1000
Raleigh, NC 27609-5738

Phone

(919) 578-8110

NPI assigned

Sep 17, 2015

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Mental Health Counselor

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• True Impact Counseling Services

  • Community/Behavioral Health Agency
  • Garner, NC
  • NPI 1124494497
  NPD Authorized official
• Monarch

  • Community/Behavioral Health Agency
  • Albemarle, NC
  • NPI 1801116405
  Medicare reassignment

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

{
    "created_epoch": "1442448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1336518554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4208 SIX FORKS RD STE 1000",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276095738",
            "telephone_number": "919-578-8110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4208 SIX FORKS RD STE 1000",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276095738",
            "telephone_number": "919-578-8110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "TRAVIS",
        "middle_name": "EDWARD",
        "credential": "LCMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-17",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "12758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IRS",
            "identifier": "47-4898841",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thaddeus Williams
• Theresa M Williams, RPH
• Tiyanna Williams
• Tomas Jamar Williams
• Traneka Williams
• Tressa Jacinda Williams, COTA/L
• Tyana A'Rie Williams, BS
• Tyler Daniel Williams, DO
• Valarie Mashea' Williams, LMBT
• Virginia Elizabeth Williams, M.ED, ATC-L

• Professional Counselor in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; 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.