Mobile Mental Wellness, LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

MOBILE MENTAL WELLNESS, LLC

Practice address

1101 Cumberland Xing # 108
Valparaiso, IN 46383-2356

Phone

(866) 413-1988

Fax

(866) 628-8599

NPI assigned

Jul 14, 2019

Last updated

Feb 2, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kimberly Travis, LCSWNPI 1194017269

Title

Owner

Phone

(866) 413-1988

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kimberly Travis, LCSW

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1194017269
  Medicare reassignment Care Compare group Authorized official
• Karen Lynn Glaza

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1114426491
  Medicare reassignment Care Compare group
• Valerie Perez, PSYD/ HSPP

  • Clinical Psychologist
  • Valparaiso, IN
  • NPI 1952651408

  IL

  Medicare reassignment NPD
• Yadira Martinez, LSW

  • Clinical Social Worker
  • Hainesville, IL
  • NPI 1538877154
  Medicare reassignment NPD
• Courtney L Hirsch

  • Mental Health Counselor
  • Valparaiso, IN
  • NPI 1396469615
  NPD (past)
• Michelle N Barraco Hatchett, LCPC, CADC, MA

  • Professional Counselor
  • Orland Park, IL
  • NPI 1881944650
  NPD (past)
• Carolina M Faulkner

  • Counselor
  • University Place, WA
  • NPI 1255068011
  NPD (past)
• Katherine Mejia, PHD

  • Clinical Psychologist
  • Chicago, IL
  • NPI 1861916710
  NPD (past)
• Krista K St James, LSW

  • Social Worker
  • Sedona, AZ
  • NPI 1295473239

  Clinical

  NPD (past)

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

{
    "created_epoch": "1563062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769990400000",
    "number": "1497307045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE MENTAL WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-14",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A",
        "authorized_official_last_name": "TRAVIS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "866-413-1988",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300007929",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael F Mirochna, M.D.
• Jena Shea Mitchell
• William K Mitchell V, DNP, CRNA
• Julie Andrea Mitchener, DNP CRNA
• Bruce Moberley, D.O.
• Mobile Physicians Group LLC
• Mobile Wellness Incorporated
• Kamala B Modur, MD
• Elizabeth Victoria Moerman, FNP
• Hermann Brice Mofang

• Multi-Specialty Clinic/Center in Valparaiso, IN
• Providers in Valparaiso, IN by specialty
• Multi-Specialty Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.