Individual provider Active NPI

Lisa Ann Dube, LCSW

  • Clinical Social Worker
  • Groveland, MA
National Provider Identifier
1245736156
Registry record updated Apr 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2025319 Issued in MA
Practice address
2 Merrimack River Rd
Groveland, MA 01834-1424
Phone
(978) 478-7207
NPI assigned
Apr 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2025319 MA Primary

Addresses

Primary practice location

2 Merrimack River Rd
Groveland, MA 01834-1424

Mailing address

2 Merrimack River Rd
Groveland, MA 01834-1424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 10, 2020 through Feb 10, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2025319MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1522540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522540800000",
    "number": "1245736156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 MERRIMACK RIVER RD",
            "city": "GROVELAND",
            "state": "MA",
            "postal_code": "018341424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MERRIMACK RIVER RD",
            "city": "GROVELAND",
            "state": "MA",
            "postal_code": "018341424",
            "telephone_number": "978-478-7207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBE",
        "first_name": "LISA",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-01",
        "last_updated": "2018-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "2025319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Groveland, MA

Sources for this page

Verify at the official NPI Registry.