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A MINDFUL SPACE THERAPY AND COACHING PLLC
NPI 1487528964
Social Worker - Clinical in Ottawa, IL

Active since September 30, 2025
1476 N 3039TH RD, OTTAWA, IL 61350(815) 324-2750 Get Directions Write a Review

NPPES record last updated: December 9, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 9, 2025, Dec 1, 2025 (2 updates tracked since 2025).

About A Mindful Space Therapy And Coaching Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

A MINDFUL SPACE THERAPY AND COACHING PLLC (NPI 1487528964) is a healthcare organization registered as a clinical in Ottawa, Illinois and active in the NPI registry since September 2025. The organization lists Maria Carolina Rubio-moore, Owner/psychotherapist, as its authorized official.

NPPES Registry Identity

NPI1487528964
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameA MINDFUL SPACE THERAPY AND COACHING PLLC
Location Address1476 N 3039TH RDOttawa, IL 61350-9032
Mailing Address1476 N 3039th RdOttawa, IL 61350-9032 · (815) 324-2750
Phone(815) 324-2750
Organization SubpartNo
Authorized OfficialMaria Carolina Rubio-mooreOwner/psychotherapist · (574) 870-1355
Enumeration DateSeptember 30, 2025
Last NPPES UpdateDecember 9, 20252 updates tracked since enumeration
NPPES CertifiedDecember 9, 2025
✔ NPI 1487528964 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
1476 N 3039TH RD, Ottawa, IL 61350
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

A Mindful Space Therapy And Coaching Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to A Mindful Space Therapy And Coaching PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Maria Rubio Moore, LCSW
Clinical Social Worker
NPI 1801280052
1476 N 3039TH RD
Ottawa, IL 61350
(574) 870-1355
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is A Mindful Space Therapy And Coaching PLLC's NPI number?

The NPI number for A Mindful Space Therapy And Coaching PLLC is 1487528964. It was assigned to this organization in the NPPES registry on September 30, 2025.

Where is A Mindful Space Therapy And Coaching PLLC located?

A Mindful Space Therapy And Coaching PLLC is located at 1476 N 3039th Rd, Ottawa, IL 61350. The listed phone number is (815) 324-2750.

What is A Mindful Space Therapy And Coaching PLLC's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is A Mindful Space Therapy And Coaching PLLC enrolled in Medicare?

Yes. A Mindful Space Therapy And Coaching PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through A Mindful Space Therapy And Coaching PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to A Mindful Space Therapy And Coaching PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for A Mindful Space Therapy And Coaching PLLC was last updated on December 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.