Provider Demographics
NPI:1881225969
Name:ROBYN TRAVIS COUNSELING LLC
Entity Type:Organization
Organization Name:ROBYN TRAVIS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBYN
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:TRAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:503-800-1708
Mailing Address - Street 1:4575 RIVER RD N
Mailing Address - Street 2:
Mailing Address - City:KEIZER
Mailing Address - State:OR
Mailing Address - Zip Code:97303-4645
Mailing Address - Country:US
Mailing Address - Phone:503-800-1708
Mailing Address - Fax:971-600-3567
Practice Address - Street 1:4575 RIVER RD N
Practice Address - Street 2:
Practice Address - City:KEIZER
Practice Address - State:OR
Practice Address - Zip Code:97303-4645
Practice Address - Country:US
Practice Address - Phone:503-800-1708
Practice Address - Fax:971-600-3567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-28
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health