Mr Travis Scott Kohl, LPC | |
677 East Main St, Suite A, Centreville, MI 49032 | |
(269) 467-1000 | |
(269) 467-3075 |
Full Name | Mr Travis Scott Kohl |
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Gender | Male |
Speciality | Counselor - Mental Health |
Location | 677 East Main St, Centreville, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1497081723 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | 6401011548 (Michigan) | Primary |
Entity Name | Community Mental Health Services Of St Joseph County |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1366438483 PECOS PAC ID: 9032178496 Enrollment ID: O20041011000172 |
Mailing Address | Practice Location Address |
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Mr Travis Scott Kohl, LPC 677 East Main St, Suite A, Centreville, MI 49032 Ph: (269) 467-1000 | Mr Travis Scott Kohl, LPC 677 East Main St, Suite A, Centreville, MI 49032 Ph: (269) 467-1000 |
Ms. Wendy Ludwig, MA, LPC, CAAC Counselor Medicare: Medicare Enrolled Practice Location: 677a East Main, Centreville, MI 49032 Phone: 269-467-1000 | |
Jessica Quintana, Counselor Medicare: Not Enrolled in Medicare Practice Location: 677 E Main St, Suite A, Centreville, MI 49032 Phone: 269-467-1000 | |
Ms. Linda Sue Overholt, MA LLP LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 338 N Fisher Ln, Centreville, MI 49032 Phone: 268-467-4270 Fax: 269-467-4270 | |
John Morrill, Counselor Medicare: Not Enrolled in Medicare Practice Location: 677 E Main St Ste A, Centreville, MI 49032 Phone: 269-467-1000 | |
Sarah Marie Fitzgerald, LPC Counselor Medicare: Medicare Enrolled Practice Location: 677 E Main St, Centreville, MI 49032 Phone: 269-467-1000 | |
Sheila Marie Guillen, LLPC, CAADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 677 E. Main St., Centreville, MI 49032 Phone: 269-467-1000 Fax: 269-467-3075 | |
Mrs. Leslie Dee Pitts, MA LLPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 677 E Main St Ste A, Centreville, MI 49032 Phone: 269-467-1000 Fax: 269-467-3075 |