Marvin Dewan Travis, B.S. ED ESE

Primary specialty

Mental Health Occupational TherapistTaxonomy code 225XM0800X

Practice address

43825 Michigan Ave Ste 2
Canton, MI 48188-2551

Phone

(734) 713-0080

NPI assigned

Jan 19, 2021

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 names 1

• Marvin Dewan Travis Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

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

{
    "created_epoch": "1611014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1467042903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43825 MICHIGAN AVE STE 2",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481882551",
            "telephone_number": "734-713-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43825 MICHIGAN AVE STE 2",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481882551",
            "telephone_number": "734-713-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVIS",
        "first_name": "MARVIN",
        "middle_name": "DEWAN",
        "credential": "B.S. ED ESE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-19",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XM0800X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARVIN",
            "last_name": "TRAVIS",
            "middle_name": "DEWAN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Ann Marie Traitses, OCCUPATIONAL THERAPY
• Transcending Trauma Institute, PLLC
• Transitions Salon
• Transitions Salon
• Ryann McKenzie Traver, LLMSW
• Robert Daniel Travis, MD
• Tri-City Physical Therapy, Inc
• Peter Mircea Trifan, PT, DPT
• Triple L Optical PLLC
• Victoria Tripp, RN

• Mental Health Occupational Therapist in Canton, MI
• Providers in Canton, MI by specialty
• Mental Health Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; 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.