Travis Edwin Gottschalk, MS, LMHC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

LH61457780 Issued in WA

Practice address

25504 159TH Ave E
Graham, WA 98338-7213

Phone

(206) 484-1131

NPI assigned

Dec 16, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1418688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1881092252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25504 159TH AVE E",
            "city": "GRAHAM",
            "state": "WA",
            "postal_code": "983387213",
            "telephone_number": "206-484-1131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25504 159TH AVE E",
            "city": "GRAHAM",
            "state": "WA",
            "postal_code": "983387213",
            "telephone_number": "206-484-1131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTSCHALK",
        "first_name": "TRAVIS",
        "middle_name": "EDWIN",
        "name_prefix": "Mr.",
        "credential": "MS, LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-16",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "LH61457780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Brandon Rae Gonzales
• Megan Lachelle Goodfellow
• Shannon Michelle Gorrie, PT, DPT, ETC.
• Debbra Gaye Gould, LMT, MMT
• Nichole Gould, CBT
• Graham Family Dental Care, PLLC
• Graham Medical Clinic
• Elizabeth G Grevey, PSYD, BCBA

• Counselor in Graham, WA
• Providers in Graham, WA by specialty
• Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.