Travis Paul Haase, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

4901 Issued in ID

Practice address

413 N Allumbaugh St
Suite 101
Boise, ID 83704-9212

Phone

(208) 323-1125

NPI assigned

Apr 5, 2012

Last updated

Apr 5, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1326336058
  Medicare reassignment

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

{
    "created_epoch": "1333584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333584000000",
    "number": "1649536418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 SUNFLOWER DR",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836867118",
            "telephone_number": "208-340-6996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 N ALLUMBAUGH ST",
            "address_2": "SUITE 101",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049212",
            "telephone_number": "208-323-1125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAASE",
        "first_name": "TRAVIS",
        "middle_name": "PAUL",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-05",
        "last_updated": "2012-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "4901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaguar Apolo Gyurcsik
• H&H Treatment Programs Inc.
• Jeffrey Ha
• Dylan Haas, LPC
• Shane Haas, PA-C
• Murtuza H Habeeb, MD
• Mariam Habib
• Stacy Marie Hackenmiller, FNP
• Kelsy Reid Hacker, PA-C
• Justin Jacobs Hacking, LPC

• Mental Health Counselor in Boise, ID
• Providers in Boise, ID by specialty
• Mental Health Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.