Katherine Dubois, LCSW (DE) LICSW (MA)

Individual provider Active NPI Clinical Social Worker · Talleyville, DE

NPI 1215535158 · NPPES record last updated May 31, 2026

Key facts

NPI
1215535158
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
Q1-0012305 (DE)
Practice address
19 Brandywine Blvd
Talleyville, DE 19803-1838
Phone
(207) 239-1480
NPI assigned
Oct 13, 2020
Sex
Female
Sole proprietor
No

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
Q1-0012305DEMDClinical Social Worker
123791MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Life Fully Lived, LLC Clinical Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 123791 MA
Clinical Social Worker 1041C0700X Q1-0012305 DE Yes

Addresses

Primary practice location

19 Brandywine Blvd
Talleyville, DE 19803-1838

Mailing address

19 Brandywine Blvd
Talleyville, DE 19803-1838
Phone (207) 239-1480

Other providers in Talleyville, DE

All providers in Talleyville, DE · Clinical Social Worker in Delaware

Sources for this page

Verify at the official NPI Registry.