Individual provider Active NPI

Debra Dubin, LCSW

  • Clinical Social Worker
  • Arlington Heights, IL
National Provider Identifier
1891813523
Registry record updated Mar 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149-002653 Issued in IL
Practice address
3255 N Arlington Heights Rd Ste 502
Arlington Heights, IL 60004-1586
Phone
(847) 219-2182
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2018

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 149-002653 IL Primary

Addresses

Primary practice location

3255 N Arlington Heights Rd Ste 502
Arlington Heights, IL 60004-1586

Mailing address

2710 Misty Woods Rd
Buffalo Grove, IL 60089-6339
Phone (847) 219-2182

Other identifiers 1

IdentifierTypeStateIssuer
149-002653OtherILLCSW

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20050712000431 IL Practitioner - Clinical Social Worker 3971539925 Practice locations: Arlington Heights, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1983
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3255 N Arlington Heights Rd
Suite 502
Arlington Heights, IL 60004-1586
Phone (847) 219-2182

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149-002653ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521504000000",
    "number": "1891813523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 MISTY WOODS RD",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600896339",
            "telephone_number": "847-219-2182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3255 N ARLINGTON HEIGHTS RD STE 502",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600041586",
            "telephone_number": "847-219-2182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBIN",
        "first_name": "DEBRA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2018-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-002653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "149-002653",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

Verify at the official NPI Registry.