Tobrina Marcella Goldbaum, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071-008-220 Issued in IL

Practice address

1043 Ridgewood Dr
Highland Park, IL 60035-4023

Phone

(847) 701-4378

NPI assigned

Jul 28, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1280275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1467766709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1043 RIDGEWOOD DR",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600354023",
            "telephone_number": "847-701-4378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1043 RIDGEWOOD DR",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600354023",
            "telephone_number": "847-701-4378"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "175 Olde Half Day Rd",
            "address_purpose": "LOCATION",
            "city": "Lincolnshire",
            "state": "IL",
            "postal_code": "600693061",
            "country_code": "US",
            "telephone_number": "847-701-4378",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLDBAUM",
        "first_name": "TOBRINA",
        "middle_name": "MARCELLA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-28",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-008-220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Glazer, M.D.
• Glueck MD, LLC
• Jennifer S Glueck, M.D.
• Alexi Gniot, PTA
• Smriti Goel, MD
• Barry Goldberg, MD
• David Goldberg, DDS, MS
• Lee A Goldfine, DDS
• Debra Benjamin Goldman, MA,BC-DMT,LCPC
• Mark Lloyd Goldstein, PHD

• Clinical Psychologist in Highland Park, IL
• Providers in Highland Park, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.