A Mindful Space Therapy and Coaching PLLC
NPI 1487528964ActiveOrganization· Social Worker, Clinical· Ottawa, IL
Social Worker, Clinical in Ottawa, Illinois, registered in NPPES in September 2025. The authorized official on file is Maria Carolina Rubio-Moore, LCSW, Owner/Psychotherapist. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1487528964 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 30, 2025 |
| Last updated in NPPES | Dec 9, 2025 |
| Certified by provider | Dec 9, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (IL) |
|---|
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