Active NPI
Jacquelyn Juanita Tobey, LLP
- Psychologist
- Plymouth, MI
National Provider Identifier
1730466632
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301012834
- Practice address
- 650 Church St RM 313
Plymouth, MI 48170-1689 - Phone
- (734) 215-7202
- Fax
- (856) 997-1717
- NPI assigned
- Nov 7, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301012834 | MI | Primary |
Addresses
Primary practice location
650 Church St RM 313
Plymouth, MI 48170-1689
Mailing address
50256 Jackson LN
Canton, MI 48188-3436
Phone (734) 968-6480
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301012834 | MI | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Creative Healers, LLC | Current | Accepting new patients | |
| Fairsky Foundation | Psychologist | Past | Accepting new patients |
Locations
650 Church St
Rm 313
Plymouth, MI 48170
Phone (734) 215-7202
Organizations & group practices 2
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.
-
- Counseling Psychologist
- Plymouth, MI
- NPI 1952907610
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620604800000",
"number": "1730466632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50256 JACKSON LN",
"city": "CANTON",
"state": "MI",
"postal_code": "481883436",
"telephone_number": "734-968-6480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 CHURCH ST RM 313",
"city": "PLYMOUTH",
"state": "MI",
"postal_code": "481701689",
"telephone_number": "734-215-7202",
"fax_number": "856-997-1717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOBEY",
"first_name": "JACQUELYN",
"middle_name": "JUANITA",
"name_prefix": "Mrs.",
"credential": "LLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-11-07",
"last_updated": "2021-05-10",
"certification_date": "2021-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301012834",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.