Active NPI
Jennifer A. Dubose, M.S., C.A.S., LMFT
- Marriage & Family Therapist
- Batavia, IL
National Provider Identifier
1760630263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 166000738
- Practice address
- 504 Houston St
Batavia, IL 60510-1842 - Phone
- (630) 326-9008
- NPI assigned
- Sep 9, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 166000738 | IL | Primary |
Addresses
Primary practice location
504 Houston St
Batavia, IL 60510-1842
Mailing address
504 Houston St
Batavia, IL 60510-1842
Phone (630) 326-9008
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Previously, effective Jul 31, 2024 through Jul 31, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 166000738 | IL | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1220918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1220918400000",
"number": "1760630263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "504 HOUSTON ST",
"city": "BATAVIA",
"state": "IL",
"postal_code": "605101842",
"telephone_number": "630-326-9008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "504 HOUSTON ST",
"city": "BATAVIA",
"state": "IL",
"postal_code": "605101842",
"telephone_number": "630-326-9008"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUBOSE",
"first_name": "JENNIFER",
"middle_name": "A.",
"credential": "M.S., C.A.S., LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-09",
"last_updated": "2008-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "IL",
"license": "166000738",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Batavia, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.