Active NPI
Authelia Updegraff, LISW
- Clinical Social Worker
- Willoughby, OH
National Provider Identifier
1851345987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- I9530
- Practice address
- 2770 Som Center Rd
#2
Willoughby, OH 44094-9111 - Phone
- (440) 516-1350
- Fax
- (440) 944-7330
- NPI assigned
- May 22, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | I9530 | OH | Primary |
Addresses
Primary practice location
2770 Som Center Rd
#2
Willoughby, OH 44094-9111
Mailing address
24800 Highpoint Rd
Beachwood, OH 44122-6041
Phone (216) 831-6611
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
| License | State | Type | Specialty |
|---|---|---|---|
| I9530 | OH | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chattree and Associates LTD | Past | Accepting new patients | |
| Psychological & Behavioral Consultants, LLC | Clinical | 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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Beachwood, OH
- NPI 1962448654
-
- Psychiatry Physician
- Beachwood, OH
- NPI 1811915713
Clinical
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1851345987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24800 HIGHPOINT RD",
"city": "BEACHWOOD",
"state": "OH",
"postal_code": "441226041",
"telephone_number": "216-831-6611",
"fax_number": "216-831-2726"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2770 SOM CENTER RD",
"address_2": "#2",
"city": "WILLOUGHBY",
"state": "OH",
"postal_code": "440949111",
"telephone_number": "440-516-1350",
"fax_number": "440-944-7330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UPDEGRAFF",
"first_name": "AUTHELIA",
"name_prefix": "Ms.",
"credential": "LISW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "I9530",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Willoughby, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.