Organization Active NPI

Amanda Dubas, LLC

  • Clinical Social Worker
  • Grand Island, NE
National Provider Identifier
1801314869
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7186 Issued in NE
Legal business name
AMANDA DUBAS, LLC
Practice address
1917 W Faidley Ave
Grand Island, NE 68803-4642
Phone
(308) 398-0350
Fax
(308) 398-0351
NPI assigned
Aug 30, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Amanda Husein, MA, PLCSW
Title
Owner
Phone
(308) 398-0350

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 7186 NE Primary

Addresses

Primary practice location

1917 W Faidley Ave
Grand Island, NE 68803-4642

Mailing address

1917 W Faidley Ave
Grand Island, NE 68803-4642
Phone (308) 398-0350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200220001524 NE Part B Supplier - Clinic/Group Practice 3971930587 Receives reassigned benefits from 1 practitioner
Practice locations: Grand Island, NE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1504051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1801314869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1917 W FAIDLEY AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034642",
            "telephone_number": "308-398-0350",
            "fax_number": "308-398-0351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1917 W FAIDLEY AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034642",
            "telephone_number": "308-398-0350",
            "fax_number": "308-398-0351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMANDA DUBAS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-30",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HUSEIN",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "308-398-0350",
        "authorized_official_credential": "MA, PLCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "7186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.