Individual provider Active NPI

Alexis Ann Wolfe, BCBA

  • Behavior Analyst
  • Mishawaka, IN
National Provider Identifier
1376207480
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-21-55751 Issued in IN
Practice address
1316 W Dragoon TRL
Mishawaka, IN 46544-4713
Phone
(574) 855-4292
NPI assigned
Oct 25, 2021
Last updated
Sep 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-21-55751 IN Primary

Addresses

Primary practice location

1316 W Dragoon TRL
Mishawaka, IN 46544-4713

Mailing address

1316 W Dragoon TRL
Mishawaka, IN 46544-4713
Phone (574) 855-4292

Other practice location 1

17106 Cleveland Rd
South Bend, IN 46635-1414
Phone (574) 855-4292

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RBT-18-56064INMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Journeys Behavior Learning Center LLC CurrentSince Nov 17, 2024 Accepting new patients

Locations

1316 W Dragoon Trl
Mishawaka, IN 46544
Phone (574) 855-4292

17106 Cleveland Rd
South Bend, IN 46635
Phone (574) 855-4292

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1376207480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1316 W DRAGOON TRL",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465444713",
            "telephone_number": "574-855-4292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1316 W DRAGOON TRL",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465444713",
            "telephone_number": "574-855-4292"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17106 Cleveland Rd",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466351414",
            "country_code": "US",
            "telephone_number": "574-855-4292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLFE",
        "first_name": "ALEXIS",
        "middle_name": "ANN",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-25",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IN",
            "license": "1-21-55751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.