Individual ProviderTravis TannerSocial WorkerBehavioral Health & Social Service ProvidersPractice Address225 W 35th St Fl 7, New York, NY 10001-1904(917) 909-2332PECOS EnrollmentBased on the most recent information from CMS, provider Travis Tanner does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 2:56 PM.Profile DetailsProvider ID1811371727Provider TypeIndividualFull NameTanner, TravisCredentialLCSWGenderMaleSole ProprietorNoEnumeration Date7/10/2015Last Updated1/12/2019Contact InformationPractice LocationPractice Address225 W 35th St Fl 7, New York, NY 10001-1904Phone(917) 909-2332Fax(917) 909-2336Mailing LocationMailing Address3149 36th St Apt 4c, Astoria, NY 11106-1055Phone(917) 909-2332Fax(917) 909-2336Provider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense087599New York