| Tics | |
|
4208 Six Forks Rd Ste 1000 Raleigh NC 27609-5738 | |
| (919) 578-8110 | |
| Not Available |
| Full Name | Tics |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 4208 Six Forks Rd Ste 1000, Raleigh, North Carolina |
| Authorized Official Name and Position | Travis Edward Williams (LCMHC) |
| Authorized Official Contact | 9199154800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tics 4208 Six Forks Rd Ste 1000 Raleigh NC 27609-5738 Ph: (919) 915-4800 | Tics 4208 Six Forks Rd Ste 1000 Raleigh NC 27609-5738 Ph: (919) 578-8110 |
| NPI Number | 1053789396 |
|---|---|
| Provider Enumeration Date | 09/03/2015 |
| Last Update Date | 12/13/2023 |
| Certification Date | 12/13/2023 |
| Medicare PECOS PAC ID | 2769832054 |
|---|---|
| Medicare Enrollment ID | O20231228003039 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053789396 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | 8845 (North Carolina) | Primary |
| Provider Name | Travis Edward Williams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336518554 PECOS PAC ID: 1456706308 Enrollment ID: I20231228003031 |
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