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Deactivated NPI 1417250697 Deactivated / Inactive NPI Male Practitioner

Dr. Marc Lewis Rathbun , PhD

Psychologist • Dallas, TX

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Marc Rathbun has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date December 10, 2010
NPI Deactivation Date January 29, 2026
Total Practice Duration ~16 Years of Practice (2010 – 2026)

Professional Overview & Biography Verified Profile Summary

Dr. Marc Rathbun, PhD was a registered Psychologist practicing in Dallas, TX. Throughout an active medical career spanning 16 years, Dr. Rathbun provided care at the practice location at 5470 GLEN LAKES DR until profile deactivation on 2026-01-29.

Practice Location & Contact Primary Location

Practice Address

5470 Glen Lakes Dr
Ste 300

Dallas, TX 752314320

Telephone 2147507117
Fax 2147507117
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist in Dallas, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 18.8 Yrs
State Avg: 22.8 Yrs
Regional Practice Density
263 Specialists

Practicing in Dallas, TX (2266 Statewide)

Telehealth Adoption Rate
9.1% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

State License TX 22764

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Roger Polan , LCSW

Social Worker - Clinical

NPI 1245229962

Licensed Clinical Social Worker

Richard Wagner , LPC

Counselor - Professional

NPI 1366612418

Licensed Professional Counselor

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated January 29, 2026

Record deactivated on January 29, 2026

NPI Profile Active December 10, 2010

NPI status registered as active in NPPES database

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Updated Practice Location December 10, 2010

Registered at 5470 GLEN LAKES DR, STE 300, DALLAS, TX 752314320 (Tel: 2147507117)

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Updated Business Mailing Address December 10, 2010

Registered at 5470 GLEN LAKES DR, STE 300, DALLAS, TX 752314320 (Tel: 2147507117)

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Provider Name / Credentials Updated December 10, 2010

Recorded as MARC RATHBUN, PH.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) December 10, 2010

Psychologist (License #22764 in TX)

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Initial NPI Registration & Enumeration December 10, 2010

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1417250697
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 10, 2010
Last Update: December 10, 2010
Deactivation Date: January 29, 2026

Mailing Address

5470 Glen Lakes Dr, Ste 300

Dallas, TX 752314320

Phone: 2147507117

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

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