Nicole Mignon Dubus, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

110673 Issued in MA

Practice address

100 Main St
Ste 15
Amesbury, MA 01913-2822

Phone

(978) 317-3088

NPI assigned

Oct 16, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1831279074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 FRIEND ST",
            "city": "AMESBURY",
            "state": "MA",
            "postal_code": "019132723",
            "telephone_number": "978-317-3088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MAIN ST",
            "address_2": "STE 15",
            "city": "AMESBURY",
            "state": "MA",
            "postal_code": "019132822",
            "telephone_number": "978-317-3088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBUS",
        "first_name": "NICOLE",
        "middle_name": "MIGNON",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "110673",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS15487",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1858751",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "460265",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "049907",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH",
            "identifier": "104468",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "P07791",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elinor M Donovan
• Mary Dow
• Dr.'S Ditolla & Little
• Melissa Driver
• Jerry Duberstein, PHD LMHC
• Joan Dumais
• Leah J Dunn
• Robert H Ebersole Jr., LMFT
• Brenda Ebode
• Janice M Eisenhaure

• Clinical Social Worker in Amesbury, MA
• Providers in Amesbury, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.

Verify at the official NPI Registry.