| The Up Center | |
|
222 W 19th St Norfolk VA 23517-2218 | |
| (757) 622-7017 | |
| (757) 640-8402 |
| Full Name | The Up Center |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 222 W 19th St, Norfolk, Virginia |
| Authorized Official Name and Position | Brenda Luverne Jones (BILLING SUPERVISOR) |
| Authorized Official Contact | 7576227017 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Up Center 222 W 19th St Norfolk VA 23517-2218 Ph: (757) 622-7017 | The Up Center 222 W 19th St Norfolk VA 23517-2218 Ph: (757) 622-7017 |
| NPI Number | 1629158159 |
|---|---|
| Provider Enumeration Date | 10/17/2006 |
| Last Update Date | 01/19/2012 |
| Medicare PECOS PAC ID | 7618009333 |
|---|---|
| Medicare Enrollment ID | O20100715000882 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629158159 | NPI | - | NPPES |
| 1538364179 | Other | VA | MARY A BRANTLEY - PROVIDER |
| 1295888501 | Other | VA | KRISTIN HARDEE-POULIN - PROVIDER |
| 1689689234 | Other | VA | FREDRICK D WESTON - PROVIDER |
| 1285737205 | Other | VA | GLORIA M SAUNDERS - PROVIDER |
| 1417028291 | Other | VA | CONSTANTINA KOUZI |
| 1215917315 | Other | VA | JAMES ZELL - PROVIDER |
| 1033273560 | Other | VA | J. KELLIE EVANS - PROVIDER |
| 1194891598 | Other | VA | ANDREA LONG - PROVIDER |
| 1487764825 | Other | VA | DEBORAH LEECY - PROVIDER |
| 1487840641 | Other | VA | SHAWN WARE-AVANT - PROVIDER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Christina D Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366769333 PECOS PAC ID: 8628102720 Enrollment ID: I20100811000422 |
| Provider Name | Jennifer Black |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912370354 PECOS PAC ID: 0840593448 Enrollment ID: I20160114000965 |
| Provider Name | Ruth Yvette Woods |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093263394 PECOS PAC ID: 5890070163 Enrollment ID: I20170329000650 |
| Provider Name | Dorothy M Goulart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821023060 PECOS PAC ID: 5092814285 Enrollment ID: I20170405001260 |
| Provider Name | Mylira Green |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780221242 PECOS PAC ID: 6406240456 Enrollment ID: I20220308002210 |
| Provider Name | Ashalee Utz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699432864 PECOS PAC ID: 0446646731 Enrollment ID: I20220414000605 |
| Provider Name | Ashlee A Collister |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770101826 PECOS PAC ID: 5193105641 Enrollment ID: I20220630001840 |
| Provider Name | James Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477281277 PECOS PAC ID: 4183092729 Enrollment ID: I20221201002146 |
| Provider Name | Jill Zaricor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396263927 PECOS PAC ID: 1658749205 Enrollment ID: I20221201002445 |
| Provider Name | Rebecca Ellis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124643788 PECOS PAC ID: 1557721610 Enrollment ID: I20230720002384 |
| Provider Name | Edica Gonzalez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740854371 PECOS PAC ID: 4880054972 Enrollment ID: I20230720004093 |
| Provider Name | April Lcsw Green |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659772812 PECOS PAC ID: 9234592601 Enrollment ID: I20230901000148 |
| Provider Name | Catherine Calletto |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528573565 PECOS PAC ID: 2668813403 Enrollment ID: I20240510003142 |
| Provider Name | Hunter Staylor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366177800 PECOS PAC ID: 7113369851 Enrollment ID: I20240524003232 |
| Provider Name | Arielle Shipp |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043828924 PECOS PAC ID: 4981146883 Enrollment ID: I20240606003263 |
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