Individual provider Active NPI

Wendy Jean Travis, LCSW

  • Clinical Social Worker
  • Warner Robins, GA
National Provider Identifier
1619046570
Registry record updated Jul 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
78 Medical Operations Squadron
Sgoh
Warner Robins, GA 31098
Phone
(478) 327-8436
NPI assigned
Nov 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X IL Primary

Addresses

Primary practice location

78 Medical Operations Squadron
Sgoh
Warner Robins, GA 31098

Mailing address

78 Medical Operations Squadron
Sgoh
Warner Robins, GA 31098
Phone (478) 327-8436

Other names 1

  • Miss Wendy Jean Wyse Former name

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

State licenses

LicenseStateTypeSpecialty
149008865ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184630400000",
    "number": "1619046570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 MEDICAL OPERATIONS SQUADRON",
            "address_2": "SGOH",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "31098",
            "telephone_number": "478-327-8436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 MEDICAL OPERATIONS SQUADRON",
            "address_2": "SGOH",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "31098",
            "telephone_number": "478-327-8436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVIS",
        "first_name": "WENDY",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WENDY",
            "last_name": "WYSE",
            "middle_name": "JEAN",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Warner Robins, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; 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.