Upward Autism Center LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

UPWARD AUTISM CENTER LLC

Practice address

4400 Brownsville Rd Ste #105 #3080
Powder Springs, GA 30127-8902

Phone

(470) 333-2051

Fax

(678) 669-2694

NPI assigned

Aug 19, 2021

Organization subpart

No

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

Authorized official

Name

Mrs. Raven Thomas, MS, BCBANPI 1083199152

Title

Owner/Center Director

Phone

(502) 338-4266

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Raven Ashley Thomas, MS, BCBA

  • Behavior Analyst
  • Kennesaw, GA
  • NPI 1083199152
  NPD Authorized official

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

{
    "created_epoch": "1629331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681171200000",
    "number": "1558037507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 BROWNSVILLE RD STE #105 #3080",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301278902",
            "telephone_number": "470-333-2051",
            "fax_number": "678-669-2694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 BROWNSVILLE RD STE #105 #3080",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301278902",
            "telephone_number": "470-333-2051",
            "fax_number": "678-669-2694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPWARD AUTISM CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-19",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "RAVEN",
        "authorized_official_title_or_position": "OWNER/CENTER DIRECTOR",
        "authorized_official_telephone_number": "502-338-4266",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS, BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBA CERTIFICATE",
            "identifier": "1-18-32530",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Blessing Udeh
• Igwebuike Moses Udeze, NP
• Judith E Ugorji
• Eseroghene Ukueku-Boyo, BS PHARMACY
• Kingsley Nwabuko Umezurike, PHARMD
• Leah Avis Urben, RPH
• Usrc Powder Springs Home LLC
• Mahaveer Vakharia, M.D.
• Susan Gail Vander Wyk, OTR
• Vensaee Investment

• All providers in Powder Springs, GA
• Behavior Analyst in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; 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.