Travis Cavazos
Individual provider Active NPI Mental Health Counselor · Bowling Green, KY
NPI 1679941595 · NPPES record last updated Sep 9, 2015
Key facts
- NPI
- 1679941595
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- LPCCCA00218829 (KY)
- Practice address
- 1048 Ashley St
Suite 201
Bowling Green, KY 42103-2449 - Phone
- (270) 904-6567
- Fax
- (270) 904-6570
- NPI assigned
- Sep 9, 2015
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPCCCA00218829 | KY | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPCCCA00218829 | KY | Yes |
Addresses
Primary practice location
1048 Ashley St
Suite 201
Bowling Green, KY 42103-2449
Mailing address
104 Reynolds Rd
Glasgow, KY 42141-1177
Phone (270) 678-4801
Other providers in Bowling Green, KY
- Patricia Ann Catlett
- Shelia Freano Catlett
- Jeremy Paul Catron
- Brian Cauley
- Diana K Cavanah
- Joseph Daniel Cecil
- Center for Behavioral Health Kentucky LLC
- Center for Pain Management
- Center for Plastic & Reconstructive Surgery PSC
- Center for Urological Treatment, PLC
All providers in Bowling Green, KY · Mental Health Counselor in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.