Unknown Individual – Counseling Psychologist, NPI 1689859803

Unknown Individual is a healthcare provider. based in Indianapolis, Indiana. specializing in Counseling Psychologist. They hold a License No. 40020551A (IN). The NPI Number for Unknown Individual is 1689859803

Main info

Organization
Inactive
36 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1689859803
Phone
(317) 581-2288
Address
10293 N MERIDIAN ST
Deactivation Date
31 July 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3178763699
Graduation Year
1990 (36 years ago)
PAC ID
6901979350
Group Practice PAC ID
4183691934
Professional Enrollment ID
I20080718000369
Data current as of
20 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

  • North Meridian Street, Spring Mill Woods, Indianapolis, Indiana, 46074:46260, United States

    SUITE 375

    INDIANAPOLIS, IN 462901123

    Phone: (317) 581-2288

    Fax: (317) 581-2295

    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.

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

Insurance plans in this area (ZIP 46290)

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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: 4183691934View full group profile

Reviews

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1689859803.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Counseling Psychologist. Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Indianapolis?
Unknown Individual currently maps to Indianapolis, Indiana in this extract.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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