NPIMap

Organization Active NPI

Mobile Wellness Incorporated

  • Clinical Social Worker
  • Valparaiso, IN
National Provider Identifier
1982292199
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MOBILE WELLNESS INCORPORATED
Practice address
1101 Cumberland Crossing Dr.
#108
Valparaiso, IN 46383
Phone
(866) 413-1988
Fax
(866) 628-8599
NPI assigned
Jan 4, 2021
Last updated
Apr 9, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2026

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

Authorized official

Name
Kimberly Travis, LCSWNPI 1194017269
Title
Ceo
Phone
(866) 413-1988

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary
Case Management Agency 251B00000X

Addresses

Primary practice location

1101 Cumberland Crossing Dr.
#108
Valparaiso, IN 46383

Mailing address

980 N Michigan Ave
Ste 1090 PMB 344989
Chicago, IL 60611-4521
Phone (866) 413-1988

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210414002004 IN Part B Supplier - Clinic/Group Practice 6800204744 Receives reassigned benefits from 5 practitioners
Practice locations: Valparaiso, IN
O20210726002274 IL Part B Supplier - Clinic/Group Practice 6800204744 Receives reassigned benefits from 4 practitioners
Practice locations: Calumet City, IL

National Provider Directory

National Provider Directory

Locations

10208 S Indianapolis Ave
Chicago, IL 60617
Phone (219) 286-4106

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1609718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775692800000",
    "number": "1982292199",
    "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 CROSSING DR.",
            "address_2": "#108",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "46383",
            "telephone_number": "866-413-1988",
            "fax_number": "866-628-8599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE WELLNESS INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-04",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A",
        "authorized_official_last_name": "TRAVIS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "866-413-1988",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.