Provider Demographics
NPI:1871481010
Name:TRAVIS, WILLIAM ALLEN
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:ALLEN
Last Name:TRAVIS
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 HOWLAND DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43230-3610
Mailing Address - Country:US
Mailing Address - Phone:614-374-7965
Mailing Address - Fax:
Practice Address - Street 1:517 HOWLAND DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43230-3610
Practice Address - Country:US
Practice Address - Phone:614-374-7965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health