Individual provider Active NPI

Desiree Dubovick, LCSW-C

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1811216625
Registry record updated May 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
13570 Issued in MD
Practice address
805 E Fayette St
Baltimore, MD 21202-4712
Phone
(410) 576-8300
Fax
(410) 576-8385
NPI assigned
May 19, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 13570 MD Primary

Addresses

Primary practice location

805 E Fayette St
Baltimore, MD 21202-4712

Mailing address

2903 Liberty Pkwy
Dundalk, MD 21222-5203
Phone (443) 286-0902

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
13570MDMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1274227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274227200000",
    "number": "1811216625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2903 LIBERTY PKWY",
            "city": "DUNDALK",
            "state": "MD",
            "postal_code": "212225203",
            "telephone_number": "443-286-0902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 E FAYETTE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212024712",
            "telephone_number": "410-576-8300",
            "fax_number": "410-576-8385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBOVICK",
        "first_name": "DESIREE",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-19",
        "last_updated": "2010-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "13570",
            "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 May 19, 2010; 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.