Individual
TRAVIS SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS, CADC I
Contact information
Practice address
78 CENTENNIAL LOOP STE A, EUGENE, OR 97401-7900
(458) 205-7602
(458) 205-7697
Mailing address
78 CENTENNIAL LOOP STE A, EUGENE, OR 97401-7900
(458) 205-7602
(458) 205-7697
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
1780712851
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780712851
—
OR
Enumeration date
10/05/2015
Last updated
05/11/2017
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