Unknown Individual – Clinical Psychologist, NPI 1699849265

Unknown Individual is a healthcare provider. based in Stockbridge, Georgia. specializing in Clinical Psychologist. They hold a License No. 1057 (GA). The NPI Number for Unknown Individual is 1699849265

Main info

Organization
Inactive
41 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1699849265
Phone
(770) 474-8400
Address
275 COUNTRY CLUB DR
Deactivation Date
20 March 2025

Doctor Profile

Medical School Name
UNIVERSITY OF FLORIDA COLLEGE OF MEDICINE
Secondary Phone
7704748400
Graduation Year
1985 (41 years ago)
PAC ID
0345415089
Group Practice PAC ID
1850389099
Professional Enrollment ID
I20111208000547
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 275, Country Club Drive, Stockbridge, Henry County, Georgia, 30281, United States

    STOCKBRIDGE, GA 302817349

    Phone: (770) 474-8400

    Fax: (770) 474-3738

    Mailing address matches the actual address.

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.

This can happen when there are no reportable CMS Open Payments records.

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.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

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

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90837Psychotherapy, 1 hour25824$0
90791Psychiatric diagnostic evaluation1212$0
View full utilization report →

Insurance plans in this area (ZIP 30281)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1850389099View full group profile
NameSpecialtyState
-GA

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1699849265; it appears in the national provider directory.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Stockbridge, Georgia for Unknown Individual; download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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