person
Travis Andrew Booth, MA,LCPC
Professional Counselor in Evanston, Illinois
NPI 1730423393

Travis Andrew Booth is a Professional Counselor based in Evanston, IL and is specialized in Professional. Travis Andrew Booth practices in Evanston, IL and has the professional credentials of MA,LCPC. The NPI Number for Travis Andrew Booth is 1730423393 and holds a License No. 178.008592 (Illinois).

The current practice location address for Travis Andrew Booth is 1007 Church St, Evanston, IL and can be reached out via phone at 847-492-1938 and via fax at 847-423-5670.

Location: 1007 Church St, Evanston, IL, 60201-3624
person
Provider Profile Details
NPI Number
1730423393
Provider Name
Travis Andrew Booth
Credential
MA,LCPC
Provider Entity Type
Individual
Gender
Male
Address
1007 Church St, Evanston, IL, 60201-3624
Phone Number
847-492-1938
Fax Number
847-423-5670
Provider Enumeration Date
11/20/2012
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
PHCP058737 01 IL PHILADELPHIA INDEMNITY INSURANCE COMPANY
institution
Provider Business Practice Location Address Details
Address
1007 Church St
City
State
Zip
60201-3624
Phone Number
847-492-1938
Fax Number
847-423-5670
person
Provider Business Mailing Address Details
Address
1007 Church St
City
State
Zip
60201-3624
Phone Number
847-492-1938
Fax Number
847-423-5670
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
178.008592 (Illinois)
Definition
Definition to come...
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