NPIMap

Organization Active NPI

Travis Corporation

Doing business as People Care Clinic

  • Mental Health Counselor
  • Roxbury, MA
National Provider Identifier
1659302396
Registry record updated Feb 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
4211 Issued in MA
Legal business name
TRAVIS CORPORATION
Doing business as
People Care Clinic
Practice address
1705 Columbus Ave.
Roxbury, MA 02119
Phone
(617) 516-5150
Fax
(617) 442-6915
NPI assigned
Jul 5, 2006
Last updated
Feb 9, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2009

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

Authorized official

Name
Bruce L Bird, PH.D.NPI 1215422159
Title
Ceo
Phone
(617) 441-1770

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 4211 MA Primary

Addresses

Primary practice location

1705 Columbus Ave.
Roxbury, MA 02119

Mailing address

1705 Columbus Ave
Roxbury, MA 02119
Phone (617) 516-5150

Other names 1

  • People Care Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

1019 Iyannough Rd
Ste 3
Hyannis, MA 02601
Phone (508) 862-8061

439 S Union St
Ste 207A
Lawrence, MA 01843
Phone (978) 681-9652

1705 Columbus Ave
Roxbury, MA 02119
Phone (617) 516-5150

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234137600000",
    "number": "1659302396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 COLUMBUS AVE",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "02119",
            "telephone_number": "617-516-5150",
            "fax_number": "617-442-6915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 COLUMBUS AVE.",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "02119",
            "telephone_number": "617-516-5150",
            "fax_number": "617-442-6915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAVIS CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2009-02-09",
        "status": "A",
        "authorized_official_last_name": "BIRD",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "617-441-1770",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "4211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "People Care Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roxbury, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2009; 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.