NPIMap

Individual provider Active NPI

Traci Elmore Dubon, LMSW

  • Social Worker
  • Atlanta, GA
National Provider Identifier
1962693135
Registry record updated Aug 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
MSW004142 Issued in GA
Practice address
1105 West Peachtree Street N.E.
Atlanta, GA 30344
Phone
(404) 853-2829
Fax
(404) 872-1636
NPI assigned
Aug 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X MSW004142 GA Primary

Addresses

Primary practice location

1105 West Peachtree Street N.E.
Atlanta, GA 30344

Mailing address

1105 West Peachtree Street N.E.
P.O. Box 7948 Station C
Atlanta, GA 30344
Phone (404) 853-2829

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
MSW004142GAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Families First Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186272000000",
    "number": "1962693135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 WEST PEACHTREE STREET N.E.",
            "address_2": "P.O. BOX 7948 STATION C",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30344",
            "telephone_number": "404-853-2829",
            "fax_number": "404-872-1636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 WEST PEACHTREE STREET N.E.",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30344",
            "telephone_number": "404-853-2829",
            "fax_number": "404-872-1636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBON",
        "first_name": "TRACI",
        "middle_name": "ELMORE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-05",
        "last_updated": "2007-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "GA",
            "license": "MSW004142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.