Jessica Marie Travis, LAMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

AMFT000776 Issued in GA

Practice address

1030 Fayetteville Rd SE
Atlanta, GA 30316-2921

Phone

(404) 486-9034

NPI assigned

May 4, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jessica Marie Goodwin Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1683158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1639868615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 ASTOR AVE SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303104841",
            "telephone_number": "832-242-4460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 FAYETTEVILLE RD SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303162921",
            "telephone_number": "404-486-9034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVIS",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "LAMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-04",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "AMFT000776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "GOODWIN",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Traveling Grace Holistic Care
• Traveling Smiles
• Thomas Travers
• Maria Traverso, NP
• Imani Ciara Travis, RN
• Natasha A Travis, MD
• Teresa Anna Travnicek
• Travon Holt DMD PC
• Latonia Michelle Trawick, NP
• Tarra Marie Trawick, FNP-BC

• Marriage & Family Therapist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Marriage & Family Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; 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.