Provider Demographics
NPI:1760971394
Name:UGBOMEH, ANDRIEL JANAE (MSSA, LSW)
Entity Type:Individual
Prefix:MRS
First Name:ANDRIEL
Middle Name:JANAE
Last Name:UGBOMEH
Suffix:
Gender:F
Credentials:MSSA, LSW
Other - Prefix:MS
Other - First Name:ANDRIEL
Other - Middle Name:JANAE
Other - Last Name:MCBRAYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW, CDCA
Mailing Address - Street 1:100 E. CAMPUS BLVD
Mailing Address - Street 2:SUITE 250 PMB 581
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235
Mailing Address - Country:US
Mailing Address - Phone:614-600-2217
Mailing Address - Fax:
Practice Address - Street 1:100 E. CAMPUS BLVD
Practice Address - Street 2:SUITE 250 PMB 581
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235
Practice Address - Country:US
Practice Address - Phone:614-600-2217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-09
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1700303104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker