Basic Information
| Provider Information | |||||||||
| NPI: | 1952728842 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DUBAY | ||||||||
| FirstName: | AIMEE | ||||||||
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| Credential: | LMHC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 147 NORMAN ST | ||||||||
| Address2: | |||||||||
| City: | WEST SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010895003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137368329 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2155 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011043301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137322120 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2014 | ||||||||
| LastUpdateDate: | 03/28/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | 8710 | MA | Y | Behavioral Health & Social Service Providers | Counselor |
ID Information
| ID | Type | State | Issuer | Description | 12529 | 01 | HEALTH NEW ENGLAND | OTHER | 1307576 | 01 | MBHP | OTHER | 997303 | 01 | MA | NETWORK HEALTH | OTHER | 042622756 | 01 | MA | COMMONWEALTH CARE ALLIANCE | OTHER | 71756 | 01 | TUFTS | OTHER | 8443 | 01 | MA | BMC | OTHER | 1307576 | 05 | MA | MEDICAID |