Provider Demographics
NPI:1689472086
Name:MUSICH PSYCHOTHERAPY PLLC
Entity type:Organization
Organization Name:MUSICH PSYCHOTHERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:MUSICH
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:773-231-7973
Mailing Address - Street 1:13880 W RUSSELL RD
Mailing Address - Street 2:
Mailing Address - City:ZION
Mailing Address - State:IL
Mailing Address - Zip Code:60099-9217
Mailing Address - Country:US
Mailing Address - Phone:773-231-7973
Mailing Address - Fax:
Practice Address - Street 1:13880 W RUSSELL RD
Practice Address - Street 2:
Practice Address - City:ZION
Practice Address - State:IL
Practice Address - Zip Code:60099-9217
Practice Address - Country:US
Practice Address - Phone:773-231-7973
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-04
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth ServiceGroup - Multi-Specialty