Active NPI
Travis J. Hall, PHD
- Clinical Psychologist
- Hamilton, NY
National Provider Identifier
1679001994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 022152
- Practice address
- 164 Broad St
Hamilton, NY 13346-9575 - Phone
- (315) 824-4600
- NPI assigned
- May 31, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 022152 | NY | Primary |
Addresses
Primary practice location
164 Broad St
Hamilton, NY 13346-9575
Mailing address
164 Broad St
Hamilton, NY 13346-9575
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 28, 2021 through May 28, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 022152 | NY | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lora a. Abraham, LCSW, P.C. | Current | Accepting new patients |
Locations
7325 State Route 5
Clinton, NY 13323
Phone (315) 859-1973
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Clinton, NY
- NPI 1316662281
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496188800000",
"number": "1679001994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "164 BROAD ST",
"city": "HAMILTON",
"state": "NY",
"postal_code": "133469575"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "164 BROAD ST",
"city": "HAMILTON",
"state": "NY",
"postal_code": "133469575",
"telephone_number": "315-824-4600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALL",
"first_name": "TRAVIS",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-05-31",
"last_updated": "2017-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "022152",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hamilton, NY
- Gregory Alan Fuller, RPH
- Kristin Elizabeth Garrity, ATC, LAT
- Ivan Darius Gowan, MD
- Andrew D Gracey, MSPT
- Jackie Jean Hagmann, LMT
- Hamilton Chiropractic Health Center, LLP
- Hamilton Critical Care and Emergency Consultants PC
- Hamilton Hearing, LLC
- Hamilton Medical Services PLLC
- Hamilton School District
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.