Provider Demographics
NPI:1215698873
Name:UP THERAPY, LLC
Entity type:Organization
Organization Name:UP THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RENEE'
Authorized Official - Middle Name:
Authorized Official - Last Name:BOOKER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, BACS
Authorized Official - Phone:504-388-1944
Mailing Address - Street 1:1901 HIGHWAY 190 APT 1422
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70448-3486
Mailing Address - Country:US
Mailing Address - Phone:504-388-1944
Mailing Address - Fax:504-899-5415
Practice Address - Street 1:1901 HIGHWAY 190 APT 1422
Practice Address - Street 2:
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70448-3486
Practice Address - Country:US
Practice Address - Phone:150-438-8194
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty