Provider Demographics
NPI:1982035929
Name:TERRY R TOBIAS PHD & ASSOCIATES, LLC
Entity Type:Organization
Organization Name:TERRY R TOBIAS PHD & ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:TOBIAS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:216-791-8009
Mailing Address - Street 1:12429 CEDAR RD
Mailing Address - Street 2:STE 16
Mailing Address - City:CLEVELAND HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44106-3163
Mailing Address - Country:US
Mailing Address - Phone:216-791-8009
Mailing Address - Fax:216-791-8013
Practice Address - Street 1:12429 CEDAR RD
Practice Address - Street 2:STE 16
Practice Address - City:CLEVELAND HTS
Practice Address - State:OH
Practice Address - Zip Code:44106-3163
Practice Address - Country:US
Practice Address - Phone:216-791-8009
Practice Address - Fax:216-791-8013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-02
Last Update Date:2017-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH4124103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHHO70960Medicare UPIN