Sally R Tobin, LICSW, LMFT

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2386 Issued in ND

Practice address

701 3Rd St NW
Jamestown, ND 58401-2963

Phone

(701) 442-2837

NPI assigned

Jun 10, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Anne Carlsen Center for Children

  • Community/Behavioral Health Agency
  • Jamestown, ND
  • NPI 1750542478
  NPD (past)

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

{
    "created_epoch": "1307664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1922393685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 3RD ST NW",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584018000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 3RD ST NW",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584012963",
            "telephone_number": "701-442-2837"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 2nd Ave S",
            "address_2": "Cass County Social Services",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581038226",
            "country_code": "US",
            "telephone_number": "701-239-6718",
            "fax_number": "701-241-5775",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1010 2nd Ave S",
            "address_2": "Cass County Social Services",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581038226",
            "country_code": "US",
            "telephone_number": "701-239-6718",
            "fax_number": "701-241-5775",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOBIN",
        "first_name": "SALLY",
        "middle_name": "R",
        "credential": "LICSW, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-10",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "ND",
            "license": "20090029",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "24962",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "2386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Whitney Trautman
• Jessica Lynn Tripp

• Clinical Social Worker in Jamestown, ND
• Providers in Jamestown, ND by specialty
• Clinical Social Worker in North Dakota

• 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.