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General NPI Number Information
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NPI Number | 1447065198
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Entity Type | Individual
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Provider Name | TRAVIS SUTTON LPC
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Gender | Male
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Dates
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Enumeration Date | 02/10/2025
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 3740 N HALSTED ST
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City | CHICAGO
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State | IL
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Zip | 60613-5653
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Country | US
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Telephone | 773-560-1829
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Fax |
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Provider Business Mailing Address
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Address Line | 3740 N HALSTED ST
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City | CHICAGO
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State | IL
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Zip | 60613-5653
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Country | US
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Telephone | 773-560-1829
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 178021273
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | 4127755
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License Number State | AK
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Taxonomy #3
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | 3590002754
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0011
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License Number State | MP
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