Provider Demographics
NPI:1295326320
Name:TOBIAS, PHYLLIS ANN (MSW, LICSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:PHYLLIS
Middle Name:ANN
Last Name:TOBIAS
Suffix:
Gender:F
Credentials:MSW, LICSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12823 TRADD ST APT 2C
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-9554
Mailing Address - Country:US
Mailing Address - Phone:317-710-9564
Mailing Address - Fax:
Practice Address - Street 1:12823 TRADD ST APT 2C
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-9554
Practice Address - Country:US
Practice Address - Phone:317-710-9564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-01
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC162951041C0700X
IN330040961041C0700X
MA1197981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical