Mr Travis James Ericksen, LPC | |
6100 Newport Rd Ste 222, Portage, MI 49002-9235 | |
(269) 488-5929 | |
(833) 599-7700 |
Full Name | Mr Travis James Ericksen |
---|---|
Gender | Male |
Speciality | Counselor - Professional |
Location | 6100 Newport Rd Ste 222, Portage, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1285878413 | NPI | - | NPPES |
1708146 | Medicaid | MI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 6401010965 (Michigan) | Primary |
Entity Name | Joy Unlimited Counseling Center Plc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1164925269 PECOS PAC ID: 7810250073 Enrollment ID: O20180423000302 |
Mailing Address | Practice Location Address |
---|---|
Mr Travis James Ericksen, LPC 6100 Newport Rd Ste 222, Portage, MI 49002-9235 Ph: (269) 488-5929 | Mr Travis James Ericksen, LPC 6100 Newport Rd Ste 222, Portage, MI 49002-9235 Ph: (269) 488-5929 |
Mrs. Pamela Regina Robinson, LLMSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 1151 W Milham Ave, Portage, MI 49024 Phone: 269-205-3356 | |
Melissa Portia Fuller, LPC Counselor Medicare: Medicare Enrolled Practice Location: 7895 Currier Dr, Portage, MI 49002 Phone: 269-910-7327 | |
Tawanda Clarke, M.A., LPC, CAADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 609 Southland Ave, Portage, MI 49024 Phone: 269-808-6556 | |
Suzanne Degraves, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1591 W Centre Ave Ste 103&105, Portage, MI 49024 Phone: 269-323-2553 | |
Amy Albertson, Counselor Medicare: Medicare Enrolled Practice Location: 1651 W Centre Ave, Portage, MI 49024 Phone: 269-366-0650 | |
Dr. Damon Delano Chambers, LPC Counselor Medicare: Medicare Enrolled Practice Location: 4621 Hanover Ave, Portage, MI 49002 Phone: 269-267-8203 | |
Dr. Charmeka S Newton, PH.D Counselor Medicare: Accepting Medicare Assignments Practice Location: 1350 W Centre Ave, Portage, MI 49024 Phone: 269-910-7327 Fax: 269-910-7328 |