Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1730423393 Individual Practitioner Male Practitioner

Travis Andrew Booth , MA, LCPC

Counselor - Professional • Evanston, IL

Professional Overview & Biography Verified Profile Summary

Travis Booth, MA, LCPC is a registered healthcare professional specializing in Counselor - Professional in Evanston, IL. Practice services are available at 1007 CHURCH ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1007 Church St
Suite 302

Evanston, IL 602013624

Telephone 8474921938
Fax 8474235670
Associated Practice Facility / Clinic
🏢 Self Design, Inc Facility NPI 1023374261

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Evanston, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 15.1 Yrs
State Avg: 17.0 Yrs
Regional Practice Density
198 Specialists

Practicing in Evanston, IL (9683 Statewide)

Telehealth Adoption Rate
1.5% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License IL 180.009981

Definition to come...

Counselor - Professional

NUCC Taxonomy Code: 101YP2500X

State License IL 178.008592

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Philadelphia Indemnity Insurance Company
PHCP058737 (IL)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

11 Associated Practitioners
Cathrina Kok , MA, LPC

Counselor - Professional

NPI 1083580112

Master of Arts, Licensed Professional Counselor

Melody Van Der Werff , LCPC

Counselor - Professional

NPI 1184803595

Licensed Clinical Professional Counselor

John Choi , LCPC

Counselor - Professional

NPI 1245876408

Licensed Clinical Professional Counselor

Erica Estes Watson , MA, LPC

Counselor - Professional

NPI 1295066355

Master of Arts, Licensed Professional Counselor

Erin Stoel , LPC

Counselor - Mental Health

NPI 1295500031

Licensed Professional Counselor

Leanna Gudel , MA, LPC

Counselor - Mental Health

NPI 1316128556

Master of Arts, Licensed Professional Counselor

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active March 07, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location March 07, 2016

Registered at 1007 CHURCH ST, SUITE 302, EVANSTON, IL 602013624 (Tel: 8474921938)

📍
Updated Business Mailing Address March 07, 2016

Registered at 1007 CHURCH ST, SUITE 302, EVANSTON, IL 602013624 (Tel: 8474921938)

👤
Provider Name / Credentials Updated March 07, 2016

Recorded as TRAVIS BOOTH, MA, LCPC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 07, 2016

Counselor (License #180.009981 in IL)

🟢
Initial NPI Registration & Enumeration November 20, 2012

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1730423393
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 20, 2012
Last Update: March 07, 2016
Sole Proprietor: Yes

Mailing Address

1007 Church St, Suite 302

Evanston, IL 602013624

Phone: 8474921938

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.