Active NPI
Travis Philip Vick, M.A.
- Professional Counselor
- Waco, TX
National Provider Identifier
1609017615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 63056
- Practice address
- 3417 Greenwood Dr
Waco, TX 76708-2250 - Phone
- (254) 292-9949
- NPI assigned
- Mar 20, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 63056 | TX | Primary |
Addresses
Primary practice location
3417 Greenwood Dr
Waco, TX 76708-2250
Mailing address
3417 Greenwood Dr
Waco, TX 76708-2250
Phone (254) 292-9949
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63056 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1237507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284422400000",
"number": "1609017615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3417 GREENWOOD DR",
"city": "WACO",
"state": "TX",
"postal_code": "767082250",
"telephone_number": "254-292-9949"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3417 GREENWOOD DR",
"city": "WACO",
"state": "TX",
"postal_code": "767082250",
"telephone_number": "254-292-9949"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VICK",
"first_name": "TRAVIS",
"middle_name": "PHILIP",
"name_prefix": "Mr.",
"credential": "M.A.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-03-20",
"last_updated": "2010-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "63056",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waco, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.