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UP THERAPY, LLC
Complete NPI Record 1215698873
Social Worker in Mandeville, LA

NPI Status: Active since January 06, 2022

Contact Information

1901 HIGHWAY 190 APT 1422
MANDEVILLE, LA
ZIP 70448
Phone: (150) 438-8194

Get Directions

Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider First Line Business Mailing Address
  6. Provider Business Mailing Address City Name
  7. Provider Business Mailing Address State Name
  8. Provider Business Mailing Address Postal Code
  9. Provider Business Mailing Address Country Code If outside U S
  10. Provider Business Mailing Address Telephone Number
  11. Provider Business Mailing Address Fax Number
  12. Provider First Line Business Practice Location Address
  13. Provider Business Practice Location Address City Name
  14. Provider Business Practice Location Address State Name
  15. Provider Business Practice Location Address Postal Code
  16. Provider Business Practice Location Address Country Code If outside U S
  17. Provider Business Practice Location Address Telephone Number
  18. Provider Enumeration Date
  19. Last Update Date
  20. Authorized Official Last Name
  21. Authorized Official First Name
  22. Authorized Official Title or Position
  23. Authorized Official Telephone Number
  24. Healthcare Provider Taxonomy Code 1
  25. Healthcare Provider Primary Taxonomy Switch 1
  26. Healthcare Provider Taxonomy Code 2
  27. Healthcare Provider Primary Taxonomy Switch 2
  28. Is Organization Subpart
  29. Authorized Official Credential Text
  30. Healthcare Provider Taxonomy Group 2
  31. NPI Certification Date

Complete NPI Dataset

This page represents the complete record for NPI 1215698873. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1215698873
Entity Type Code: 2
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: UNAVAIL
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Provider First Line Business Mailing Address: 1901 HIGHWAY 190 APT 1422
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: MANDEVILLE
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address State Name: LA
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 704483486
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 5043881944
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Fax Number: 5048995415
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address: 1901 HIGHWAY 190 APT 1422
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: MANDEVILLE
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: LA
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 704483486
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number: 1504388194
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date: 1/6/2022
The telephone number associated with the location address of the provider being identified.
Last Update Date: 9/6/2022
The date that a record was last updated or changed.
Authorized Official Last Name: BOOKER
The date that a record was last updated or changed.
Authorized Official First Name: RENEE'
The first name of the authorized official.
Authorized Official Title or Position: OWNER
The first name of the authorized official.
Authorized Official Telephone Number: 5043881944
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 261Q00000X
The 10-position telephone number of the authorized official.
Healthcare Provider Primary Taxonomy Switch 1: N
Healthcare Provider Taxonomy Code 2: 104100000X
Healthcare Provider Primary Taxonomy Switch 2: Y
Is Organization Subpart: N
Authorized Official Credential Text: LCSW, BACS
Healthcare Provider Taxonomy Group 2: 193400000X SINGLE SPECIALTY GROUP
NPI Certification Date: 9/6/2022