person
Mr. Travis James Ericksen, LPC
Professional Counselor in Portage, Michigan
NPI 1285878413

Travis James Ericksen is a Professional Counselor based in Portage, MI and is specialized in Professional. Travis James Ericksen practices in Portage, MI and has the professional credentials of LPC. The NPI Number for Travis James Ericksen is 1285878413 and holds a License No. 6401010965 (Michigan).

The current practice location address for Travis James Ericksen is 6100 Newport Rd Ste 222, Portage, MI and can be reached out via phone at 269-488-5929 and via fax at 833-599-7700.

Location: 6100 Newport Rd Ste 222, Portage, MI, 49002-9235
person
Provider Profile Details
NPI Number
1285878413
Provider Name
Travis James Ericksen
Credential
LPC
Provider Entity Type
Individual
Gender
Male
Address
6100 Newport Rd Ste 222, Portage, MI, 49002-9235
Phone Number
269-488-5929
Fax Number
833-599-7700
Provider Enumeration Date
05/01/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1708146 05 MI
institution
Provider Business Practice Location Address Details
Address
6100 Newport Rd Ste 222
City
State
Zip
49002-9235
Phone Number
269-488-5929
Fax Number
833-599-7700
person
Provider Business Mailing Address Details
Address
6100 Newport Rd Ste 222
City
State
Zip
49002-9235
Phone Number
269-488-5929
Fax Number
833-599-7700
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
6401010965 (Michigan)
Definition
Definition to come...
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