Provider Demographics
NPI:1588537617
Name:UMBRA THERAPY, PLLC
Entity type:Organization
Organization Name:UMBRA THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OUTPATIENT THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KELSEY
Authorized Official - Middle Name:L
Authorized Official - Last Name:CUOMO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:704-774-5040
Mailing Address - Street 1:1125 E MOREHEAD ST STE 207
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-2849
Mailing Address - Country:US
Mailing Address - Phone:704-774-5040
Mailing Address - Fax:
Practice Address - Street 1:1125 E MOREHEAD ST STE 207
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-2849
Practice Address - Country:US
Practice Address - Phone:704-774-5040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-25
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty