MR. KRISTIAN GLYNN TRAVIS – Mental Health Counselor, NPI 1295348233

MR. KRISTIAN GLYNN TRAVIS is a healthcare provider. based in Salem, Massachusetts. specializing in MENTAL HEALTH COUNSELOR. The NPI Number for MR. KRISTIAN GLYNN TRAVIS is 1295348233

Main info

Male
Sole Proprietor
11 Years Of Experience
Accepts Medicare Assignment
Name
MR. KRISTIAN GLYNN TRAVIS
NPI
1295348233
Phone
(978) 744-7905
Address
110 BOSTON ST
Enumeration Date
28 August 2020
Last Update Date
28 August 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9782643619
Graduation Year
2015 (11 years ago)
PAC ID
1254865280
Group Practice PAC ID
3274430590
Professional Enrollment ID
I20241113000485
Address ID
MA017203743AC380XXAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience25
Completeness75
Years active:5State licenses:0Digital endpointsOther names

2,116 MENTAL HEALTH COUNSELOR in MA

Provider Addresses for MR. KRISTIAN GLYNN TRAVIS

  • 110 BOSTON ST

    SALEM, MA 019701402

    Phone: (978) 744-7905

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-11-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241113000485IMental Health CounselorMATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 01970)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3274430590View full group profile
NameSpecialtyState
Clinical Social WorkerMA
Mental Health CounselorMA
Clinical Social WorkerMA
Mental Health CounselorMA
Mental Health CounselorMA
Clinical Social WorkerMA
Mental Health CounselorMA
Mental Health CounselorMA
Mental Health CounselorMA
Mental Health CounselorMA

Reviews

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Frequently asked questions

Is there an official ID for MR. KRISTIAN GLYNN TRAVIS in U.S. healthcare records?
The official identifier for MR. KRISTIAN GLYNN TRAVIS is NPI 1295348233.
Is MR. KRISTIAN GLYNN TRAVIS still an active registrant?
MR. KRISTIAN GLYNN TRAVIS carries an active NPI according to the public dataset.
What expertise is attributed to MR. KRISTIAN GLYNN TRAVIS?
MR. KRISTIAN GLYNN TRAVIS's specialty line reads Mental Health Counselor. Clinical services aligned with this taxonomy classification.
What practice footprint exists for MR. KRISTIAN GLYNN TRAVIS?
Travel planning: use Salem, Massachusetts as the reference point for MR. KRISTIAN GLYNN TRAVIS, then confirm.
Can I trust this NPI listing for MR. KRISTIAN GLYNN TRAVIS?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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