Unknown Individual – Clinical Psychologist, NPI 1588773501

Unknown Individual is a healthcare provider. based in Boynton beach, Florida. specializing in Clinical Psychologist. They hold a License No. PY 5386 (FL). The NPI Number for Unknown Individual is 1588773501

Main info

Organization
Inactive
33 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1588773501
Phone
(561) 737-4886
Address
11211 S MILITARY TR
Deactivation Date
25 January 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5617374886
Graduation Year
1993 (33 years ago)
PAC ID
5890693808
Professional Enrollment ID
I20130621000291
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 11211 S MILITARY TR

    #522

    BOYNTON BEACH, FL 33436

    Phone: (561) 737-4886

    Type: Mailing

  • All Friends Impact Services, Inc., 1375, Gateway Boulevard, Boynton Beach, Palm Beach County, Florida, 33426, United States

    BOYNTON BEACH, FL 33426

    Phone: (561) 737-4886

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

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Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33436)

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Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1588773501.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Boynton Beach, Florida as a primary anchor for Unknown Individual unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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