Individual provider Active NPI

Sonia Dubose, MSW, LCSW, CADC

  • Clinical Social Worker
  • Gurnee, IL
National Provider Identifier
1194195024
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.027190 Issued in IL
Practice address
1761 N Dilleys Rd
Gurnee, IL 60031-1711
Phone
(312) 608-7369
NPI assigned
Oct 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.027190 IL Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 36580 IL
Mental Health Counselor 101YM0800X 149.027190 IL
Social Worker 104100000X 150.108061 IL
Student in an Organized Health Care Education/Training Program 390200000X
Counselor 101Y00000X 150.108061 IL

Addresses

Primary practice location

1761 N Dilleys Rd
Gurnee, IL 60031-1711

Mailing address

PO Box 22
North Chicago, IL 60064-0022
Phone (312) 608-7369

Other practice location 1

PO Box 22
North Chicago, IL 60064-0022
Phone (312) 608-7369

Other practice location 2

2025 Washington St
Waukegan, IL 60085-5131
Phone (847) 360-1020 ext. 1029

Other identifiers 1

IdentifierTypeStateIssuer
1194195024OtherILMMI

Other names 1

  • Sonia Dubose Other name

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
36580ILMDAddiction (Substance Use Disorder) Counselor
150.108061ILMDSocial Worker
149.027190ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
1 In Ah Million Addiction (Substance Use Disorder) Current Accepting new patients

Organizations & group practices 1

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": "1444003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1194195024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22",
            "city": "NORTH CHICAGO",
            "state": "IL",
            "postal_code": "600640022",
            "telephone_number": "312-608-7369",
            "fax_number": "847-984-5639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1761 N DILLEYS RD",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600311711",
            "telephone_number": "312-608-7369"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "PO Box 22",
            "address_purpose": "LOCATION",
            "city": "North Chicago",
            "state": "IL",
            "postal_code": "600640022",
            "country_code": "US",
            "telephone_number": "312-608-7369",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2025 Washington St",
            "address_purpose": "LOCATION",
            "city": "Waukegan",
            "state": "IL",
            "postal_code": "600855131",
            "country_code": "US",
            "telephone_number": "847-360-1020 x1029",
            "fax_number": "847-360-1020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUBOSE",
        "first_name": "SONIA",
        "credential": "MSW, LCSW, CADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-05",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.027190",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "36580",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "149.027190",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150.108061",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "150.108061",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MMI",
            "identifier": "1194195024",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SONIA",
            "last_name": "DUBOSE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Gurnee, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; 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.