TRAVIS ANDREW BOOTH MA LCPC NPI 1730423393

NPI Information

NPI: 1730423393
Provider Name: TRAVIS ANDREW BOOTH, MA, LCPC
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
1007 CHURCH ST
SUITE 302
EVANSTON, IL
ZIP 60201
Phone: (847) 492-1938
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Travis Andrew Booth, MA, LCPC is a professional counselor in Evanston, IL. Travis Andrew Booth, MA, LCPC NPI is 1730423393. 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:

1007 CHURCH ST
SUITE 302
EVANSTON, IL
ZIP 60201-624
Phone: (847) 492-1938
Fax: (847) 423-5670

The enumeration date for this NPI number is 11/20/2012 and was last updated on 3/7/2016.

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	101YP2500X	Counselor	Professional	178.008592	ILLINOIS	No
2	101YP2500X	Counselor	Professional	180.009981	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	PHCP058737	OTHER	ILLINOIS	PHILADELPHIA INDEMNITY INSURANCE COMPANY

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: 11/14/2023

NPI Synchronization or Removal

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