NPIMap

Organization Active NPI

Underdue Social Services

  • Community/Behavioral Health Agency
  • Stockbridge, GA
National Provider Identifier
1871634824
Registry record updated Dec 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
UNDERDUE SOCIAL SERVICES
Practice address
165 Burke St
Suite 109
Stockbridge, GA 30281-3463
Phone
(770) 389-9886
NPI assigned
Feb 12, 2007
Last updated
Dec 14, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2010

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

Authorized official

Name
Miss Kimberly Underdue, LCSWNPI 1356575476
Title
Ceo
Phone
(770) 389-9886

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

165 Burke St
Suite 109
Stockbridge, GA 30281-3463

Mailing address

1071 Laurel Ridge Dr
McDonough, GA 30252-8432
Phone (678) 851-9509

Other identifiers 4

IdentifierTypeStateIssuer
10048022OtherGAAMERIGROUP
205814758AOtherGACENPATICO
205814758AMedicaidGA
833744000OtherGAMAGELLAN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292284800000",
    "number": "1871634824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1071 LAUREL RIDGE DR",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302528432",
            "telephone_number": "678-851-9509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 BURKE ST",
            "address_2": "SUITE 109",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302813463",
            "telephone_number": "770-389-9886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNDERDUE SOCIAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2010-12-14",
        "status": "A",
        "authorized_official_last_name": "UNDERDUE",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-389-9886",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10048022",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CENPATICO",
            "identifier": "205814758A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205814758A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "833744000",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2010; 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.