Antonia Travisano, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

B1-0011441 Issued in DE

Practice address

100 Commerce Dr
Building 100, Ste 300
Newark, DE 19713-2878

Phone

(302) 224-1400

NPI assigned

Apr 10, 2020

Sex

Female

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

Enrolled in DE

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mid-Atlantic Behavioral Health, LLCGroup PAC ID 3375620016, 88 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.

• Mid-Atlantic Behavioral Health, LLC

  • Intellectual & Developmental Disabilities Psychologist
  • Newark, DE
  • NPI 1871719872

  Clinical

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1586476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1376162214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 COMMERCE DR",
            "address_2": "BUILDING 100, STE 300",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COMMERCE DR",
            "address_2": "BUILDING 100, STE 300",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132878",
            "telephone_number": "302-224-1400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "431 Meadowlark St",
            "address_purpose": "LOCATION",
            "city": "Shaw AFB",
            "state": "SC",
            "postal_code": "291525019",
            "country_code": "US",
            "telephone_number": "803-895-6199",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Wilford Hall Ambulatory Surgical Center",
            "address_2": "1100 Wilford Hall Loop, Bldg. 4554, 59, MDW/GME",
            "address_purpose": "LOCATION",
            "city": "JBSA Lackland",
            "state": "TX",
            "postal_code": "782369908",
            "country_code": "US",
            "telephone_number": "210-292-5972",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAVISANO",
        "first_name": "ANTONIA",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-10",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810007634",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "DE",
            "license": "B1-0011441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tranquility Counseling, Inc.
• Tranquility Wellness LLC
• Translog LLC
• Transparency Home Infusion Service, LLC
• Mary Transue
• Michael Travisano, PSY.D., PSYCHOLOGIST
• Kelly Marie Travitz, PHYSICIAN ASSISTANT
• Jakub Trawinski, PA-C
• David Michael Traxler, FNP
• Katie Traylor

• Clinical Psychologist in Newark, DE
• Providers in Newark, DE by specialty
• Clinical Psychologist in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; 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.