Active NPI
Casey Dubac
- Mental Health Counselor
- Baltimore, MD
National Provider Identifier
1740864412
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 301 Saint Paul St Ste 409
Baltimore, MD 21202-2102 - Phone
- (443) 449-5604
- NPI assigned
- May 10, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | LGP9551 | MD | |
| Mental Health Counselor | 101YM0800X | MD | Primary |
Addresses
Primary practice location
301 Saint Paul St Ste 409
Baltimore, MD 21202-2102
Mailing address
10042 The Mending Wall
Columbia, MD 21044-1711
Phone (410) 718-8298
Other practice location 1
10042 The Mending Wall
Columbia, MD 21044-1711
Phone (410) 718-8298
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2019
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
66 E Flagler St
Miami, FL 33130-1807
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LGP9551 | MD | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PA | Mental Health | Current | Accepting new patients |
Locations
8300 Boone Blvd
Ste 500
Vienna, VA 22182
Phone (703) 884-2598
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641081600000",
"number": "1740864412",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10042 THE MENDING WALL",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210441711",
"telephone_number": "410-718-8298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 SAINT PAUL ST STE 409",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212022102",
"telephone_number": "443-449-5604"
}
],
"practiceLocations": [
{
"address_1": "10042 The Mending Wall",
"address_purpose": "LOCATION",
"city": "Columbia",
"state": "MD",
"postal_code": "210441711",
"country_code": "US",
"telephone_number": "410-718-8298",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DUBAC",
"first_name": "CASEY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-05-10",
"last_updated": "2022-01-02",
"certification_date": "2022-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MD",
"license": "LGP9551",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MD",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2022; 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.