=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700734829
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TRAVIS CHANCE BOYD ALC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/17/2026
-----------------------------------------------------
Last Update Date | 03/17/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 277 VILLAGE PKWY
-----------------------------------------------------
City | HELENA
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35080-4028
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-624-3076
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7112 4TH AVE S
-----------------------------------------------------
City | BIRMINGHAM
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35206-5134
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-908-0681
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number | ALC04662
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------