Individual provider Active NPI

Heather J Ufberg, PSY.D.

  • Clinical Child & Adolescent Psychologist
  • Pittsburgh, PA
National Provider Identifier
1265776942
Registry record updated Apr 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
PS016555 Issued in PA
Practice address
810 Clairton Blvd Ste 500600
Pittsburgh, PA 15236-5505
Phone
(412) 650-1100
Fax
(412) 650-1101
NPI assigned
Nov 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Psychologist 103TR0400X PS016555 PA
School Psychologist 103TS0200X PS016555 PA
Clinical Child & Adolescent Psychologist 103TC2200X PS016555 PA Primary

Addresses

Primary practice location

810 Clairton Blvd Ste 500600
Pittsburgh, PA 15236-5505

Mailing address

1405 Shady Ave
Pittsburgh, PA 15217-1350
Phone (412) 420-2253

Other identifiers 1

IdentifierTypeStateIssuer
102782329-0001MedicaidPA

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PS016555PAMDRehabilitation Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Regional Medical Center PastSince Apr 26, 2020 Accepting new patients

Organizations & group practices 1

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": "1353283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556064000000",
    "number": "1265776942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 SHADY AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152171350",
            "telephone_number": "412-420-2253",
            "fax_number": "412-420-2510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 CLAIRTON BLVD STE 500600",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152365505",
            "telephone_number": "412-650-1100",
            "fax_number": "412-650-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UFBERG",
        "first_name": "HEATHER",
        "middle_name": "J",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-19",
        "last_updated": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "PA",
            "license": "PS016555",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "PA",
            "license": "PS016555",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "PA",
            "license": "PS016555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102782329-0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; 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.