MEDICARE: JESSICA N DUBEY LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	6801117134	MI

General Provider Information

NPI Number	:	1255817193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA N DUBEY LMSW

Provider Business Mailing Address
First Line	:	19794 VERMANDER AVE
Second Line	:
City	:	CLINTON TWP
State	:	MI
Zip	:	48035-4717
Country	:	US
Telephone Number	:	586-909-9473
Fax Number	:

Provider Business Practice Location Address
First Line	:	2510 S TELEGRAPH RD # L231
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48302-0241
Country	:	US
Telephone Number	:	269-389-0432
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2018
Last Update Date	:	12/19/2023

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