Travis Smith is a Mental Health in Chubbuck, Idaho. Travis Smith practices all healthcare services and medical treatments related to Mental Health. The NPI Number for Travis Smith is 1114015039. The last update date is 2007-07-09.
Travis Smith's current location address is 4460 Kings Way Ste 2, Chubbuck, Idaho. You can contact this provider via phone number 2082371711 and fax number 2082375192. The mailing address for Travis Smith is 4460 Kings Way Ste 2, Chubbuck, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Travis Smith |
|---|---|
| Address | 4460 Kings Way Ste 2, Chubbuck, Idaho |
| Phone Number | 2082371711 |
| Fax Number | 2082375192 |
| Sole Proprietor | Y |
| Credentials | LPC |
NPI Number Detail
| NPI Number | 1114015039 |
|---|---|
| Provider Enumeration Date | 2006-10-10 |
| Last Updated Date | 2007-07-09 |
Provider Mailing Address Detail
| Address | 4460 Kings Way Ste 2 |
|---|---|
| City | Chubbuck |
| State | Idaho (ID) |
| Post Code | 832021900 |
| Phone Number | 2082371711 |
| Fax Number | 2082375192 |
Provider's Primary Taxonomy Detail
| Speciality | Mental Health |
|---|---|
| Taxonomy | 101Ym0800X |
| Licence No | LPC3685 |
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Definition: A counselor who helps people manage conditions like depression, anxiety, grief, relationship issues, and more. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 807107600 | ID | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Travis Smith by the Centers for Medicare & Medicaid Services?
The Travis Smith has been issued the NPI (National Provider Identifier) 1114015039 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please provide the complete street address where Travis Smith is physically located?
The Travis Smith is physically situated at the following address: 4460 Kings Way Ste 2, Chubbuck, ID, 832021900.
What is Travis Smith's specialized field of practice, and what is the corresponding taxonomy classification code?
The Travis Smith's area of specialization is Mental Health, and the corresponding taxonomy code that categorizes this field of practice is 101Ym0800X.
When did Travis Smith receive its 1114015039 assignment?
The Travis Smith was assigned its 1114015039 on 2006-10-10, which is the date when this unique identifier was issued to the organization.
As of what date were the Travis Smith's details last updated?
The information pertaining to the Travis Smith, including its address, specialty, and other details, was most recently updated on 2007-07-09.