Active NPI
John Dubosh, LLP
- Clinical Social Worker
- Wyandotte, MI
National Provider Identifier
1407957384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801062200
- Practice address
- 2333 Biddle Ave
Wyandotte, MI 48192-4668 - Phone
- (734) 246-6000
- NPI assigned
- Sep 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Psychologist | 103TA0400X | |||
| Clinical Social Worker | 1041C0700X | 6801062200 | MI | Primary |
Addresses
Primary practice location
2333 Biddle Ave
Wyandotte, MI 48192-4668
Mailing address
1640 Fort St
Ste D Attn Denise
Trenton, MI 48183-2040
Phone (734) 391-3057
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093940272 | Other | GROUP NPI HENRY FORD WYANDOTTE | |
| 0H21692 | Other | MI | BLUE CROSS |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jdubosh13175@direct.hfhs.org | Direct |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801062200 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616025600000",
"number": "1407957384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1640 FORT ST",
"address_2": "STE D ATTN DENISE",
"city": "TRENTON",
"state": "MI",
"postal_code": "481832040",
"telephone_number": "734-391-3057",
"fax_number": "734-391-3052"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2333 BIDDLE AVE",
"city": "WYANDOTTE",
"state": "MI",
"postal_code": "481924668",
"telephone_number": "734-246-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUBOSH",
"first_name": "JOHN",
"credential": "LLP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-26",
"last_updated": "2021-03-18",
"certification_date": "2021-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TA0400X",
"taxonomy_group": "",
"desc": "Psychologist, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801062200",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI HENRY FORD WYANDOTTE",
"identifier": "1093940272",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "0H21692",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jdubosh13175@direct.hfhs.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2333 Biddle Ave",
"city": "Wyandotte",
"state": "MI",
"country_code": "US",
"postal_code": "481924668",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Wyandotte, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.