Sandra Travis, CMHT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1213 Maria LN
Iuka, MS 38852-1135

Phone

(662) 423-3332

Fax

(662) 286-8095

NPI assigned

Jan 18, 2008

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1200614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200614400000",
    "number": "1770769887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 839",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388350839",
            "telephone_number": "662-286-2152",
            "fax_number": "662-286-8095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 MARIA LN",
            "city": "IUKA",
            "state": "MS",
            "postal_code": "388521135",
            "telephone_number": "662-423-3332",
            "fax_number": "662-286-8095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVIS",
        "first_name": "SANDRA",
        "credential": "CMHT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-18",
        "last_updated": "2008-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tishomingo Health Services, Inc.
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• Tishomingo Health Services, Inc.
• Amy Gurley Tomlin
• Wendy J. Trickey, MSN, FNP-C
• Deanna Marie Underwood, CCC-SLP
• Jamie Leigh Vanderford, RN
• Ashli Richardson Vandiver
• Larry Keith Vuncannon

• Mental Health Counselor in Iuka, MS
• Providers in Iuka, MS by specialty
• Mental Health Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2008; 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.