Individual provider Active NPI

Tonya Friberg Warren, PSY.D.

  • Clinical Psychologist
  • Plymouth, NH
National Provider Identifier
1316977424
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1183 Issued in NH
Practice address
101 Boulder Point Dr Ste 1
Plymouth, NH 03264-3170
Phone
(603) 536-4000
Fax
(603) 536-4000
NPI assigned
Jul 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2940 NC
Clinical Psychologist 103TC0700X 1183 NH Primary

Addresses

Primary practice location

101 Boulder Point Dr Ste 1
Plymouth, NH 03264-3170

Mailing address

101 Boulder Point Dr Ste 1
Plymouth, NH 03264-3170
Phone (603) 536-4000

Other identifiers 1

IdentifierTypeStateIssuer
LICENSEOtherNC2940 PSY.D HCP-P

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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

Enrollment IDStateProvider typePAC IDDetails
I20090728000565 NH Practitioner - Clinical Psychologist 7911905401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-State Health CenterGroup PAC ID 1951363563, 32 clinicians

Practice addresses (Care Compare)

101 Boulder Point Dr
Plymouth, NH 03264-3170
Phone 60353640001004

28 Main St
Plymouth, NH 03264-1440
Phone (603) 536-4000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1183NHMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-State Health Center Current Accepting new patients

Locations

101 Boulder Point Dr
Ste 1
Plymouth, NH 03264
Phone (603) 238-3537

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1316977424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BOULDER POINT DR STE 1",
            "city": "PLYMOUTH",
            "state": "NH",
            "postal_code": "032643170",
            "telephone_number": "603-536-4000",
            "fax_number": "603-536-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BOULDER POINT DR STE 1",
            "city": "PLYMOUTH",
            "state": "NH",
            "postal_code": "032643170",
            "telephone_number": "603-536-4000",
            "fax_number": "603-536-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "TONYA",
        "middle_name": "FRIBERG",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "2940",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NH",
            "license": "1183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "2940 PSY.D  HCP-P",
            "identifier": "LICENSE",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, NH

Sources for this page

Verify at the official NPI Registry.