Active NPI
Phyllis Ann Tobias, MSW, LICSW, LCSW
- Clinical Social Worker
- Carmel, IN
National Provider Identifier
1295326320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 119798
- Practice address
- 12823 Tradd St Apt 2C
Carmel, IN 46032-9554 - Phone
- (317) 710-9564
- NPI assigned
- Feb 1, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LC16295 | ME | |
| Clinical Social Worker | 1041C0700X | 33004096 | IN | |
| Clinical Social Worker | 1041C0700X | 119798 | MA | Primary |
Addresses
Primary practice location
12823 Tradd St Apt 2C
Carmel, IN 46032-9554
Mailing address
12823 Tradd St Apt 2C
Carmel, IN 46032-9554
Phone (317) 710-9564
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 1, 2024 through Oct 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33004096 | IN | MD | Clinical Social Worker |
| 119798 | MA | MD | Clinical Social Worker |
| LC16295 | ME | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706572800000",
"number": "1295326320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12823 TRADD ST APT 2C",
"city": "CARMEL",
"state": "IN",
"postal_code": "460329554",
"telephone_number": "317-710-9564"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12823 TRADD ST APT 2C",
"city": "CARMEL",
"state": "IN",
"postal_code": "460329554",
"telephone_number": "317-710-9564"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOBIAS",
"first_name": "PHYLLIS",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "MSW, LICSW, LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-02-01",
"last_updated": "2024-01-30",
"certification_date": "2024-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ME",
"license": "LC16295",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "33004096",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "119798",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carmel, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.