Individual provider · Type 1 NPI

Travis Gordon

Professional Counselor · Grand Rapids, MI

NPI number 1104488105 Active

Practice location

4867 E Beltline Ave NE, Building #1, Suite 4
Grand Rapids, MI 49525

Call (616) 232-6050 Map

Mailing address

1001 E Beltline Ave NE
Grand Rapids, MI 49525-5803

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500X6451017462 (MI)

Professional Counselor: Definition to come...

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About NPI 1104488105

Travis Gordon's National Provider Identifier is 1104488105, issued on Jul 1, 2019. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Grand Rapids, MI. The record was last updated on Dec 22, 2021.