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General NPI Number Information
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NPI Number | 1104760271
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Entity Type | Individual
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Provider Name | TRAVIS COWART LMHC
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Gender | Male
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Dates
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Enumeration Date | 04/17/2026
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Last Update Date | 04/17/2026
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Provider Practice Location Address
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Address Line | 510 S 4TH ST STE 600
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City | FULTON
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State | NY
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Zip | 13069-2952
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Country | US
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Telephone | 315-598-4790
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Fax | 315-593-6195
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Provider Business Mailing Address
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Address Line | 61 DELANO ST
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City | PULASKI
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State | NY
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Zip | 13142-1400
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Country | US
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Telephone | 315-298-6564
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Fax | 315-298-3968
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 017834
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License Number State | NY
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