Healthcare Provider Details

I. General information

NPI: 1649135146
Provider Name (Legal Business Name): TRAVIS ATKINSON, LCSW, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 PARK AVE S FL 11
NEW YORK NY
10003-1626
US

IV. Provider business mailing address

215 PARK AVE S FL 11
NEW YORK NY
10003-1626
US

V. Phone/Fax

Practice location:
  • Phone: 212-725-7774
  • Fax:
Mailing address:
  • Phone: 212-725-7774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TRAVIS ATKINSON
Title or Position: OWNER
Credential: LCSW
Phone: 212-933-9332