Jennifer Dubuque, LCMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

068.0134279 Issued in VT

Practice address

Island Pond Health Center
82 Maple St
Island Pond, VT 05846

Phone

(802) 723-4300

Fax

(802) 723-4544

NPI assigned

Feb 11, 2021

Last updated

Feb 11, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VT

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

Mental Health Counselor

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northern Counties Health Care IncGroup PAC ID 2860300936, 48 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Jennifer Dubuque, PLLC

  • Mental Health Counselor
  • West Burke, VT
  • NPI 1073308672
  Medicare reassignment NPD Authorized official
• Northern Counties Health Care Inc

  • Federally Qualified Health Center (FQHC)
  • St Johnsbury, VT
  • NPI 1649236225
  Medicare reassignment Care Compare group NPD
• Northern Counties Health Care, Inc.

  dba Northern Express Care Newport

  • Federally Qualified Health Center (FQHC)
  • Newport, VT
  • NPI 1003564931
  NPD

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

{
    "created_epoch": "1613001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1982296869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 SHERMAN DR",
            "city": "ST JOHNSBURY",
            "state": "VT",
            "postal_code": "058199811",
            "telephone_number": "802-748-9405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ISLAND POND HEALTH CENTER",
            "address_2": "82 MAPLE ST",
            "city": "ISLAND POND",
            "state": "VT",
            "postal_code": "05846",
            "telephone_number": "802-723-4300",
            "fax_number": "802-723-4544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBUQUE",
        "first_name": "JENNIFER",
        "credential": "LCMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-11",
        "last_updated": "2021-02-11",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VT",
            "license": "068.0134279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF VERMONT",
            "identifier": "068.0134279",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily A. Cote, FNP-BC
• June V. Goodband
• Peter Harris, MD
• Tina Heck, NP
• Daniel Keller, DDS
• James L Lontine, PA

• Mental Health Counselor in Island Pond, VT
• Providers in Island Pond, VT by specialty
• Mental Health Counselor in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2021; 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.