Kimberly Travis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34006318A Issued in IN

Practice address

980 N Michigan Ave
Ste 1090 PMB 344989
Chicago, IL 60611-4521

Phone

(866) 413-1988

Fax

(866) 628-8599

NPI assigned

May 9, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN, IL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Social Worker

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mobile Wellness IncorporatedGroup PAC ID 6800204744, 2 clinicians

Mobile Mental Wellness, LLCGroup PAC ID 9234461310, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mobile Mental Wellness, LLC

  • Multi-Specialty Clinic/Center
  • Valparaiso, IN
  • NPI 1497307045

  IL

  Medicare reassignment Care Compare group Authorized official
• Mobile Wellness Incorporated

  • Clinical Social Worker
  • Valparaiso, IN
  • NPI 1982292199

  IL

  Medicare reassignment Care Compare group Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1304899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769472000000",
    "number": "1194017269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 CUMBERLAND XING # 108",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463832356",
            "telephone_number": "866-413-1988",
            "fax_number": "866-628-8599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 N MICHIGAN AVE",
            "address_2": "STE 1090 PMB 344989",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114521",
            "telephone_number": "866-413-1988",
            "fax_number": "866-628-8599"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 Cumberland Xing # 108",
            "address_purpose": "LOCATION",
            "city": "Valparaiso",
            "state": "IN",
            "postal_code": "463832356",
            "country_code": "US",
            "telephone_number": "866-413-1988",
            "fax_number": "866-628-8599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAVIS",
        "first_name": "KIMBERLY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-09",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34006318A",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "149.014508",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith Travers, PT, MTC
• Sarah Traverso
• Adam Randolph Travis, M.D.
• Cynthia B. Travis, N.P.
• Irene Barbara Travis
• Michael J Travis, PT, DPT
• Marjorie Travnik
• Emma C Trawick, MD
• Christopher Traxler, DDS
• Candace Traylor-Holt, PHARMD

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.