Individual provider Active NPI

Erika Updegrove, PSYD

  • Clinical Psychologist
  • Glen Allen, VA
National Provider Identifier
1811278575
Registry record updated Apr 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
022916 Issued in NY
Practice address
4701 Cox Rd
Glen Allen, VA 23060-6802
Phone
(860) 788-6404
Fax
(860) 829-0495
NPI assigned
Sep 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X
Clinical Psychologist 103TC0700X 022916 NY Primary

Addresses

Primary practice location

4701 Cox Rd
Glen Allen, VA 23060-6802

Mailing address

6 Southside Rd
Danvers, MA 01923-1409
Phone (978) 762-8352

Other practice location 1

6 Southside Rd
Danvers, MA 01923-1409
Phone (978) 762-8352

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

NPI Registry JSON

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

{
    "created_epoch": "1315353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1811278575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 SOUTHSIDE RD",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019231409",
            "telephone_number": "978-762-8352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 COX RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230606802",
            "telephone_number": "860-788-6404",
            "fax_number": "860-829-0495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 Southside Rd",
            "address_purpose": "LOCATION",
            "city": "Danvers",
            "state": "MA",
            "postal_code": "019231409",
            "country_code": "US",
            "telephone_number": "978-762-8352",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UPDEGROVE",
        "first_name": "ERIKA",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-07",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "022916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Allen, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2020; 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.