Individual provider Active NPI

Eva Duboff, LLPC

  • Mental Health Counselor
  • Oak Park, MI
National Provider Identifier
1053003590
Registry record updated May 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6451022979 Issued in MI
Practice address
24175 Sherman St
Oak Park, MI 48237-1862
Phone
(415) 420-4525
NPI assigned
May 23, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6451022979 MI Primary

Addresses

Primary practice location

24175 Sherman St
Oak Park, MI 48237-1862

Mailing address

24175 Sherman St
Oak Park, MI 48237-1862
Phone (415) 420-4525

Other practice location 1

23231 Woodward Ave
Ferndale, MI 48220-1361
Phone (248) 581-8777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6451022979MIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Past Accepting new patients
Hetal Patel, M.D. P.C. PastSince Sep 25, 2022 Accepting new patients
Fairsky Foundation PastSince May 16, 2016 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1684800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1053003590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24175 SHERMAN ST",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482371862",
            "telephone_number": "415-420-4525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24175 SHERMAN ST",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482371862",
            "telephone_number": "415-420-4525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23231 Woodward Ave",
            "address_purpose": "LOCATION",
            "city": "Ferndale",
            "state": "MI",
            "postal_code": "482201361",
            "country_code": "US",
            "telephone_number": "248-581-8777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUBOFF",
        "first_name": "EVA",
        "credential": "LLPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-23",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6451022979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.