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General NPI Number Information
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NPI Number | 1801939897
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Entity Type | Individual
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Provider Name | JOAN THERESE TRAVIS M.S.W.
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Gender | Female
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 3717 GOVERNMENT ST SUITE 3
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City | ALEXANDRIA
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State | LA
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Zip | 71302-3358
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Country | US
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Telephone | 318-442-4199
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Fax | 318-487-8798
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Provider Business Mailing Address
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Address Line | 119 DEERBROOK TRL
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City | PINEVILLE
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State | LA
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Zip | 71360-2609
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Country | US
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Telephone | 318-640-2827
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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 | 4531
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 4531
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 4531
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License Number State | LA
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