Individual provider Active NPI

Debra Lee Tobin, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1861089419
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149019676 Issued in IL
Practice address
1040 W Adams St Unit 446
Chicago, IL 60607-3097
Phone
(812) 630-0438
NPI assigned
Dec 30, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149019676 IL Primary

Addresses

Primary practice location

1040 W Adams St Unit 446
Chicago, IL 60607-3097

Mailing address

1040 W Adams St Unit 446
Chicago, IL 60607-3097
Phone (812) 630-0438

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

LicenseStateTypeSpecialty
149019676ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1609286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1861089419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 W ADAMS ST UNIT 446",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606073097",
            "telephone_number": "812-630-0438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 W ADAMS ST UNIT 446",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606073097",
            "telephone_number": "812-630-0438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOBIN",
        "first_name": "DEBRA",
        "middle_name": "LEE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-30",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149019676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2020; 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.