Avis J. Dublin, MSW, LCSW, P-LCAS

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C007395 Issued in NC

Practice address

100 Garrison Ave
Clayton, NC 27520-6767

Phone

(919) 632-2074

NPI assigned

Aug 18, 2011

Last updated

Aug 18, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2009

Medicare assignment

May accept Medicare assignment

Group practices

Johnston CountyGroup PAC ID 8224011861, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: avis.dublin.1@32647.direct.athenahealth.com

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

• Johnston County Public Health Department

  • State or Local Public Health Clinic/Center
  • Smithfield, NC
  • NPI 1528157211
  Medicare reassignment Care Compare group NPD
• County of Johnston North Carolina

  • State or Local Public Health Clinic/Center
  • Smithfield, NC
  • NPI 1710241534

  Clinical

  NPD

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

{
    "created_epoch": "1313625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313625600000",
    "number": "1366722589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41513",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276291513",
            "telephone_number": "919-632-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 GARRISON AVE",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275206767",
            "telephone_number": "919-632-2074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBLIN",
        "first_name": "AVIS",
        "middle_name": "J.",
        "credential": "MSW, LCSW, P-LCAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-18",
        "last_updated": "2011-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C007395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rod L Drake
• Susan Draper
• Drawn With Purpose
• Drops of Healing, PLLC
• Michael Drummond, RPH, MBA
• Staci Pessetti Dubois, PA
• John Duffy II, LMBT#2912
• Caitlin Colleena Dumont, DPT
• Maxwell Mase Dunfey
• Christopher F Dunn, PT OCS

• Clinical Social Worker in Clayton, NC
• Providers in Clayton, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.