1. Home
  2. Directory
  3. Oregon
  4. Coburg
  5. Counselor
  6. NPI Profile
Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

TRAVIS SHADDY
NPI 1174449201
Counselor - Addiction (Substance Use Disorder) in Coburg, OR

Active since June 24, 2026
1 SERENITY LN, COBURG, OR 97408(541) 687-1110 Get Directions Write a Review

NPPES record added: June 24, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Travis Shaddy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TRAVIS SHADDY (NPI 1174449201) is an individual addiction (substance use disorder) provider in Coburg, Oregon, licensed in Oregon (T-25-6129) and active in the NPI registry since June 2026.

NPPES Registry Identity

NPI1174449201
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameTRAVIS SHADDY
Location Address1 SERENITY LNCoburg, OR 97408-9350
Mailing Address1 Serenity LnCoburg, OR 97408-9350 · (541) 687-1110
Phone(541) 687-1110
Sole ProprietorNo
Enumeration DateJune 24, 2026
NPPES CertifiedJune 24, 2026
✔ NPI 1174449201 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in OR · T-25-6129
1 SERENITY LN, Coburg, OR 97408
Open in Google Maps ↗

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EMMITT ADAIR QMHP, CADC III, SAP
Counselor (Addiction (Substance Use Disorder))
1 SERENITY LN
COBURG, OR 97408
Lane County (541) 284-8605
MASON ANTHONY MARIN CADC-R, CRM 1
Counselor (Addiction (Substance Use Disorder))
1 SERENITY LN
COBURG, OR 97408
Lane County (541) 606-3308
JENAE HULSEY KATELYN HULSEY
Counselor (Addiction (Substance Use Disorder))
1 SERENITY LN
COBURG, OR 97408
Lane County (541) 687-1110
JACLYN BOGNER MS
Counselor (Mental Health)
1 SERENITY LN
COBURG, OR 97408
Lane County (541) 687-1110
SARAH ELIZABETH BUCK QMHA-R
Counselor (Mental Health)
1 SERENITY LN
COBURG, OR 97408
Lane County (541) 687-1110
HEATHERANN CHARLENE HELMS CADCR
Counselor (Addiction (Substance Use Disorder))
1 SERENITY LN
COBURG, OR 97408
Lane County (541) 513-6855
CHRISTOPHER BOWLING
Counselor (Addiction (Substance Use Disorder))
1 SERENITY LN
COBURG, OR 97408
Lane County (541) 687-1110
HANNAH KREEGER
Counselor (Addiction (Substance Use Disorder))
1 SERENITY LN
COBURG, OR 97408
Lane County (541) 687-1110

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Travis Shaddy's NPI number?

The NPI number for Travis Shaddy is 1174449201. It was assigned to this individual provider in the NPPES registry on June 24, 2026.

Where is Travis Shaddy located?

Travis Shaddy practices at 1 Serenity Ln, Coburg, OR 97408. The listed phone number is (541) 687-1110.

What is Travis Shaddy's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Travis Shaddy was last updated on June 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 49 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.