Individual
DR. RICHARD D TRAVIS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D, LCP
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
180003461
IL
103TC0700X
Clinical Psychologist
Primary
071.008003
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0009932335
BCBS IL
IL
01
—
11723317
AETNA
IL
01
—
581473
VALUE OPTIONS
IL
01
—
802121000
MAGELLAN
IL
Enumeration date
10/23/2006
Last updated
01/17/2011
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