Unknown Individual – Adult Psychiatric/Mental Health Clinical Nurse Specialist, NPI 1013931492

Adult Psychiatric/Mental Health Clinical Nurse Specialist

Unknown Individual is a healthcare provider. based in Portland, Maine. specializing in Adult Psychiatric/Mental Health Clinical Nurse Specialist. They hold a License No. R026582 (ME). The NPI Number for Unknown Individual is 1013931492

Main info

Organization

Inactive

37 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1013931492

Phone

(207) 871-0013

Address

413 LUDLOW ST

Deactivation Date

12 December 2024

Doctor Profile

Medical School Name

OTHER

Secondary Phone

2079340111

Graduation Year

1989 (37 years ago)

PAC ID

1557357258

Professional Enrollment ID

I20040420001381

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

Loading map...

Provider Addresses for Unknown Individual

413, Ludlow Street, Rosemont, Portland, Cumberland County, Maine, 04102, United States
PORTLAND, ME 041021544
Phone: (207) 871-0013
Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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 04102)

Loading plans...

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

Can I verify Unknown Individual with an NPI only?

You can start verification with NPI 1013931492 for Unknown Individual, then check state licensing separately.

What dates should I check for Unknown Individual's activity?

We display what the registry publishes: Unknown Individual appears inactive there.

What taxonomy line describes Unknown Individual?

For research purposes, treat Unknown Individual as Adult Psychiatric/Mental Health Clinical Nurse Specialist in this dataset. Clinical services aligned with this taxonomy classification.

Does Unknown Individual list a practice location?

Patients near Portland, Maine may find Unknown Individual in results; validate coverage separately.

Is the information about Unknown Individual up to date?

Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."