Provider Demographics
NPI:1548573728
Name:SATTERLEE, TRAVIS RICHARD (LCPC)
Entity type:Individual
Prefix:MR
First Name:TRAVIS
Middle Name:RICHARD
Last Name:SATTERLEE
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 LAKE ST
Mailing Address - Street 2:APARTMENT 2 SOUTH
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-2641
Mailing Address - Country:US
Mailing Address - Phone:773-736-1447
Mailing Address - Fax:773-736-6970
Practice Address - Street 1:4300 W IRVING PARK RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-2825
Practice Address - Country:US
Practice Address - Phone:773-736-1447
Practice Address - Fax:773-736-6870
Is Sole Proprietor?:No
Enumeration Date:2010-07-16
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180007115101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional