MR. TRAVIS C TOLL (NPI# 1902094949) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902094949 |
| Entity Type | Individual |
| Full Name | MR. TRAVIS C TOLL |
| Practice Address |
1175 E Main St Ste 1c Medford OR 97504-7457 |
| Mailing Address |
715 Sw Ramsey Ave Grants Pass OR 97527-5500 |
| Practice Telephone | 5417720127 |
| Practice Fax Number | 5417720966 |
| Mailing Telephone | 5419565463 |
| Mailing Fax Number | 5412953085 |
| Enumeration Date | 2007-10-03 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| N | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities | ||
| N | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2413 2nd St, Eureka, CA 955010811 | 7072699590 |
| Street Address |
1175 E MAIN ST STE 1C |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-7457 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407337264 | Marlon Campos | Counselor | 1175 E Main St Ste 1c, Medford, OR 97504-7457 | 2018-08-28 |
| 1881108926 | Heather Nichole Daw | Counselor | 1175 E Main St Ste 1c, Medford, OR 97504-7457 | 2017-11-28 |
| 1982118022 | Jeremy Jones | Counselor | 1175 E Main St Ste 1c, Medford, OR 97504-7457 | 2017-11-28 |
| 1811409667 | Casandra Lynn Anderrson | Counselor | 1175 E Main St Ste 1c, Medford, OR 97504-7457 | 2017-11-02 |
| 1821500125 | Sarah Hollingworth | Counselor | 1175 E Main St Ste 1c, Medford, OR 97504-7457 | 2017-10-26 |
| 1306358783 | Anne Lois Dupree | Peer Specialist | 1175 E Main St Ste 1c, Medford, OR 97504-7457 | 2017-10-25 |
| 1881104057 | Aubrey Shaw | Counselor | 1175 E Main St Ste 1c, Medford, OR 97504-7457 | 2017-10-02 |
| 1437673688 | Lauren Vail | Psychologist | 1175 E Main St Ste 1c, Medford, OR 97504-7457 | 2017-07-31 |
| 1730600867 | Wei Tseng | Peer Specialist | 1175 E Main St Ste 1c, Medford, OR 97504-7457 | 2017-06-28 |
| 1669902599 | Chedric Robert Monahan | Social Worker | 1175 E Main St Ste 1c, Medford, OR 97504-7457 | 2017-06-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225673833 | Lydia D Sneed | Behavioral Analyst | 3707 Citation Way, Suite 102, Medford, OR 97504 | 2019-11-07 |
| 1114577368 | Heather Ashley Fronek | Nurse Practitioner | 2825 E. Barnett Rd., Medford, OR 97504 | 2019-09-18 |
| 1255809109 | Justin Blasdel | Technician, Health Information | 3250 Lone Pine Rd, Medford, OR 97504 | 2018-11-08 |
| 1396220133 | Aimee K Michel | Massage Therapist | 3550 National Dr., Medford, OR 97504 | 2018-09-27 |
| 1437646908 | Zola Dental Medford LLC | Dentist | 922 E Main, Medford, OR 97504 | 2018-04-19 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1023547536 | Joshua Morgan Rice | Dentist | 1117 E Main St Ste 1, Medford, OR 97504 | 2017-06-08 |
| 1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
| 1811443542 | Taya Adams | Doula | 1201 Progress Dr #90, Medford, OR 97504 | 2016-09-01 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| Find all providers in zip 97504 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922658830 | Michelle Anne Zona | Counselor | 100 George Hassett Dr, Medford, MA 02155 | 2019-09-13 |
| 1689223901 | Holly Hermes | Counselor | 48 Hawthorne St, Medford, OR 97504-7114 | 2019-09-09 |
| 1417473554 | Elysee H. Castor | Counselor | 5 High St., Suite 101, Medford, MA 02155 | 2017-08-21 |
| 1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
| 1336597541 | Joanna Lea Ballard | Counselor | 1175 E Main St Ste C1, Medford, OR 97504-7457 | 2016-05-27 |
| 1386018240 | Sarie R Scully | Counselor | 26 Horseshoe Curv, Medford, NJ 08055-9751 | 2015-11-16 |
| 1992103451 | Sean Alexander Mickelson | Counselor | 358 S Oakdale Ave, Medford, OR 97501-3131 | 2014-12-16 |
| 1134472863 | Lynette J Milligan | Counselor | 142 N Ivy St Ste 2, Medford, OR 97501-2758 | 2012-10-18 |
| 1154687689 | Phylicia Mcdonald | Counselor | 176 Jerome St, Medford, MA 02155-3535 | 2012-04-10 |
| 1215205901 | Shelly Hohl | Counselor | 1000 E Main St Bldg B, Medford, OR 97504-7449 | 2011-12-08 |
| Find all providers in MEDFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.