Eric F Dubow, PH.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

3792 Issued in OH

Practice address

822 East Merry Street Psychological Services Center
300 Psychology Building, Bowling Green State University
Bowling Green, OH 43403-0232

Phone

(419) 372-2540

Fax

(419) 372-2533

NPI assigned

Apr 3, 2008

Last updated

Apr 3, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1207180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207180800000",
    "number": "1730352360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "822 EAST MERRY STREET PSYCHOLOGICAL SERVICES CENTER",
            "address_2": "300 PSYCHOLOGY BUILDING, BOWLING GREEN STATE UNIVERSITY",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434030232",
            "telephone_number": "419-372-2540",
            "fax_number": "419-372-2533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 EAST MERRY STREET PSYCHOLOGICAL SERVICES CENTER",
            "address_2": "300 PSYCHOLOGY BUILDING, BOWLING GREEN STATE UNIVERSITY",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434030232",
            "telephone_number": "419-372-2540",
            "fax_number": "419-372-2533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBOW",
        "first_name": "ERIC",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-03",
        "last_updated": "2008-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "3792",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "OH",
            "license": "3792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0705599",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Child & Adolescent Psychologist in Bowling Green, OH
• Providers in Bowling Green, OH by specialty
• Clinical Child & Adolescent Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2008; 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.