Individual provider Active NPI

Ashley Brooke Underwood Ulbricht, BCBA

  • Behavior Analyst
  • Charleston, SC
National Provider Identifier
1043634637
Registry record updated Apr 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-15-20994
Practice address
828 Wappoo Rd
828 Wappoo Road
Charleston, SC 29407-5865
Phone
(843) 297-8470
Fax
(843) 278-9319
NPI assigned
Feb 18, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-15-20994 Primary

Addresses

Primary practice location

828 Wappoo Rd
828 Wappoo Road
Charleston, SC 29407-5865

Mailing address

828 Wappoo Rd
828 Wappoo Road
Charleston, SC 29407-5865
Phone (843) 297-8470

Other names 1

  • Ms. Ashley Brooke Underwood Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
ABA Outreach, LLC Past Accepting new patients
ABA Outreach Behavior Analyst Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1392681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492473600000",
    "number": "1043634637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "828 WAPPOO RD",
            "address_2": "828 WAPPOO ROAD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294075865",
            "telephone_number": "843-297-8470",
            "fax_number": "843-278-9319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "828 WAPPOO RD",
            "address_2": "828 WAPPOO ROAD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294075865",
            "telephone_number": "843-297-8470",
            "fax_number": "843-278-9319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULBRICHT",
        "first_name": "ASHLEY",
        "middle_name": "BROOKE UNDERWOOD",
        "name_prefix": "Mrs.",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-18",
        "last_updated": "2017-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-15-20994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "UNDERWOOD",
            "middle_name": "BROOKE",
            "prefix": "MS.",
            "credential": "BCBA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2017; 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.