Travis Mark Quinlan, LICSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1101 E 78TH St Ste 100
Bloomington, MN 55420-1402

Phone

(952) 854-5034

NPI assigned

Jan 11, 2019

Sex

Male

Sole proprietor

No

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)

Enrolled

Practice roles

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.

• Family Support Services Inc.

  • Mental Health Counselor
  • New Brighton, MN
  • NPI 1467549220
  NPD (past)

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

{
    "created_epoch": "1547164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1821561952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 E 78TH ST STE 100",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554201402",
            "telephone_number": "952-854-5034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 E 78TH ST STE 100",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554201402",
            "telephone_number": "952-854-5034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14148 Atwood Ct",
            "address_purpose": "LOCATION",
            "city": "Rosemount",
            "state": "MN",
            "postal_code": "550683594",
            "country_code": "US",
            "telephone_number": "507-330-2884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUINLAN",
        "first_name": "TRAVIS",
        "middle_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-11",
        "last_updated": "2021-03-18",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philip Richard Quamme
• Janet M Quarn, ANP
• Nancy Lee Quast
• Victoria Quevedo
• Taylor Marie Quickstrom
• Jenna Hassanein Raad
• Najma Rabi
• Hannah Marie Rademacher
• Danielle Lynne Radke, CRNA
• Mary Ragsdale, NP

• Mental Health Counselor in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; 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.