Upward Support Services, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

UPWARD SUPPORT SERVICES, LLC

Practice address

1710 Douglas Dr N Ste 225P
Golden Valley, MN 55422-4365

Phone

(612) 208-3068

NPI assigned

Jun 14, 2024

Organization subpart

No

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

Authorized official

Name

Gebremariam Alem Gebremicael, LICSWNPI 1285997528

Title

Owner

Phone

(612) 208-3068

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

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

• Gebremariam Alem Gebremicael

  • Social Worker
  • Minneapolis, MN
  • NPI 1285997528
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1718323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718323200000",
    "number": "1982447264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 DOUGLAS DR N STE 225P",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224365",
            "telephone_number": "612-208-3068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 DOUGLAS DR N STE 225P",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224365",
            "telephone_number": "612-208-3068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPWARD SUPPORT SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-14",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A",
        "authorized_official_last_name": "GEBREMICAEL",
        "authorized_official_first_name": "GEBREMARIAM",
        "authorized_official_middle_name": "ALEM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-208-3068",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mary Louise Ulrickson, MD
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• Luke Utecht, PSY.D.
• Paige Elizabeth Vaden, PT, DPT
• Valley Health

• Adult Mental Health Clinic/Center in Golden Valley, MN
• Providers in Golden Valley, MN by specialty
• Adult Mental Health Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.