Unknown Individual – Clinical Psychologist, NPI 1003034570

Unknown Individual is a healthcare provider. based in Waterville, Maine. specializing in Clinical Psychologist. They hold a License No. PS482 (ME). The NPI Number for Unknown Individual is 1003034570

Main info

Organization
Inactive
44 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1003034570
Phone
(207) 873-2231
Address
2 ELM ST
Deactivation Date
7 February 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2078732231
Graduation Year
1982 (44 years ago)
PAC ID
8729023312
Professional Enrollment ID
I20050623000811
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

Provider Addresses for Unknown Individual

  • 2 ELM ST

    WATERVILLE, ME 049015905

    Phone: (207) 873-2231

    Fax: (207) 872-9578

    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 04901)

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Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1003034570 is assigned to Unknown Individual under the national enumeration system.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
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 Waterville, Maine for Unknown Individual; download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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