Shae R Travis, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LC12935 Issued in MD

Practice address

120 Waterfront St #2300
Ste 420
National Harbor, MD 20745-1122

Phone

(301) 778-8566

NPI assigned

Nov 27, 2020

Last updated

Dec 6, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Beneficence Center for Counseling LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • National Harbor, MD
  • NPI 1285440990
  NPD Authorized official

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

{
    "created_epoch": "1606435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1629672936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 WATERFRONT ST #2300",
            "address_2": "STE 420",
            "city": "NATIONAL HARBOR",
            "state": "MD",
            "postal_code": "207451122",
            "telephone_number": "301-778-8566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 WATERFRONT ST #2300",
            "address_2": "STE 420",
            "city": "NATIONAL HARBOR",
            "state": "MD",
            "postal_code": "207451122",
            "telephone_number": "301-778-8566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVIS",
        "first_name": "SHAE",
        "middle_name": "R",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-27",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "DC",
            "license": "PRC200001564",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC12935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatric Psychological & Consultation Services, LLC
• Precision Orthopedics and Sports Medicine
• Southern Maryland Endoscopy Center
• Sunrise Psychological Assessment Services LLC
• Surgcenter at National Harbor, LLC (Harborside Surgery Center)
• Shellee Wilson, RN, IBCLC

• Professional Counselor in National Harbor, MD
• Providers in National Harbor, MD by specialty
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; 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.