Leigh Ann Upshaw

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05997800 Issued in NJ

Practice address

4211 Sherman Ave
Millville, NJ 08332-1005

Phone

(609) 338-3067

NPI assigned

Jul 21, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1013580760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4211 SHERMAN AVE",
            "city": "MILLVILLE",
            "state": "NJ",
            "postal_code": "083321005",
            "telephone_number": "609-338-3067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 SHERMAN AVE",
            "city": "MILLVILLE",
            "state": "NJ",
            "postal_code": "083321005",
            "telephone_number": "609-338-3067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPSHAW",
        "first_name": "LEIGH ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-21",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05997800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele Michael Tucker, HIGH SCHOOL DIPLOMA
• Ebony Turner
• Melvin Turner Jr.
• Jill K Tyler, RN APN-C
• Union Lake Supermarket LLC
• Valmar Surgical Supplies Inc
• Village Drive Healthcare Urban Renewal LLC
• Voca Corporation of New Jersey
• Wal-Mart Stores East LP
• Wal-Mart Stores East, L.P.

• All providers in Millville, NJ
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.