Mary Travis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

52564 Issued in TX

Practice address

400 Airport Rd
Terrell, TX 75160-4302

Phone

(972) 524-4159

Fax

(972) 563-4433

NPI assigned

Jan 29, 2014

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

Enrolled in TX

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.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Assurasource LTDGroup PAC ID 8123125580, 61 clinicians

Mental Health Specialty Group PAGroup PAC ID 8921466228, 726 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Assurasource LTD

  • Clinical Social Worker
  • Plano, TX
  • NPI 1194746016
  Medicare reassignment Care Compare group NPD
• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  TX

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1390953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390953600000",
    "number": "1932522729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 747",
            "city": "TERRELL",
            "state": "TX",
            "postal_code": "751600014",
            "telephone_number": "972-524-4159",
            "fax_number": "972-563-4433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 AIRPORT RD",
            "city": "TERRELL",
            "state": "TX",
            "postal_code": "751604302",
            "telephone_number": "972-524-4159",
            "fax_number": "972-563-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVIS",
        "first_name": "MARY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-29",
        "last_updated": "2014-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "52564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Austin Thomas III, D.D.S.
• Stephanie Mariya Thomas, DDS
• Walter Irving Thomas II, RPH
• William O Thomason, PH.D
• Ana Gabriela Torres-Rojas, FNP-C
• Trudream Consulting LLC
• Giovanie Valencia Aguilar
• Lindsey Varner
• Ramesh P Vasani, MD
• Deepti Vats, MD

• Clinical Social Worker in Terrell, TX
• Providers in Terrell, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.