Marc Jay Tobin, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

002833 Issued in CT

Practice address

22 Crescent Rd
Westport, CT 06880-4542

Phone

(203) 376-3776

Fax

(203) 397-4919

NPI assigned

Feb 22, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Sep 20, 2016 through Sep 20, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1203638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223596800000",
    "number": "1679742886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 FOUNTAIN ST",
            "address_2": "B3",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065151847",
            "telephone_number": "203-376-3776",
            "fax_number": "203-397-4919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 CRESCENT RD",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068804542",
            "telephone_number": "203-376-3776",
            "fax_number": "203-397-4919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOBIN",
        "first_name": "MARC",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-22",
        "last_updated": "2008-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "002833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adrian K Thomas, PTA
• Kristen Tibbetts
• Karen Marie Tie, M.D.
• Bernadette Timungwa
• Caren Jo Tishfield, RDN
• Corey G Toby, LCSW
• Town of Westport
• Tracy a. Livecchi, LCSW, LLC
• Tracy Margolin LMFT LLC
• Triple Point Acupuncture Wellness, PLLC

• Clinical Psychologist in Westport, CT
• Providers in Westport, CT by specialty
• Clinical Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.