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Organization

MOBILE MENTAL WELLNESS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KIMBERLY TRAVIS LCSW (OWNER)
(866) 413-1988
Entity
Organization

Contact information

Practice address
1101 CUMBERLAND XING # 108, VALPARAISO, IN 46383-2356
(866) 413-1988
(866) 628-8599
Mailing address
980 N MICHIGAN AVE, STE 1090 PMB 344989, CHICAGO, IL 60611-4521
(866) 413-1988
(866) 628-8599

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
1041C0700X
Clinical Social Worker
261QM1300X
Multi-Specialty Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300007929
IN
Enumeration date
07/14/2019
Last updated
02/02/2026
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