Individual provider Active NPI

Allison Lynne Dublo, LCSW

  • Clinical Social Worker
  • Mulkeytown, IL
National Provider Identifier
1942490867
Registry record updated Jul 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
4484 Belgium Rd
Mulkeytown, IL 62865-2220
Phone
(618) 559-3672
NPI assigned
Jul 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2007

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 IL Primary

Addresses

Primary practice location

4484 Belgium Rd
Mulkeytown, IL 62865-2220

Mailing address

4484 Belgium Rd
Mulkeytown, IL 62865-2220
Phone (618) 559-3672

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
149.012529ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185408000000",
    "number": "1942490867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4484 BELGIUM RD",
            "city": "MULKEYTOWN",
            "state": "IL",
            "postal_code": "628652220",
            "telephone_number": "618-559-3672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4484 BELGIUM RD",
            "city": "MULKEYTOWN",
            "state": "IL",
            "postal_code": "628652220",
            "telephone_number": "618-559-3672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBLO",
        "first_name": "ALLISON",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-26",
        "last_updated": "2007-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mulkeytown, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2007; 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.