Active NPI
Laura Travisano, LPCC
- Mental Health Counselor
- Boulder, CO
National Provider Identifier
1962198481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LPCC.0020455
- Practice address
- 4752 Franklin Dr
Boulder, CO 80301-6214 - Phone
- (978) 870-4804
- NPI assigned
- Apr 17, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPCC.0020455 | CO | Primary |
Addresses
Primary practice location
4752 Franklin Dr
Boulder, CO 80301-6214
Mailing address
4752 Franklin Dr
Boulder, CO 80301-6214
Phone (978) 870-4804
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPCC.0020455 | CO | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681689600000",
"number": "1962198481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4752 FRANKLIN DR",
"city": "BOULDER",
"state": "CO",
"postal_code": "803016214",
"telephone_number": "978-870-4804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4752 FRANKLIN DR",
"city": "BOULDER",
"state": "CO",
"postal_code": "803016214",
"telephone_number": "978-870-4804"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAVISANO",
"first_name": "LAURA",
"name_prefix": "Miss",
"credential": "LPCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-04-17",
"last_updated": "2023-04-17",
"certification_date": "2023-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CO",
"license": "LPCC.0020455",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.