TRAVIS VANDERBILT MA LADC LPCC NPI 1659000255

NPI Information

NPI: 1659000255
Provider Name: TRAVIS VANDERBILT, MA, LADC, LPCC
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
680 STEWART AVE
SAINT PAUL, MN
ZIP 55102
Phone: (651) 292-2420
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Travis Vanderbilt, MA, LADC, LPCC is a mental health counselor in Saint Paul, MN. Travis Vanderbilt, MA, LADC, LPCC NPI is 1659000255. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

680 STEWART AVE
SAINT PAUL, MN
ZIP 55102-117
Phone: (651) 292-2420
Fax: (651) 292-2436

The enumeration date for this NPI number is 6/8/2022 and was last updated on 6/8/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	303534	MINNESOTA	No
2	101YM0800X	Counselor	Mental Health	3253	MINNESOTA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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