Unknown Individual – Psychologist, NPI 1013984335

Unknown Individual is a healthcare provider. based in Portland, Maine. specializing in Psychologist. They hold a License No. 406 (ME). The NPI Number for Unknown Individual is 1013984335

Main info

Organization
Inactive
47 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1013984335
Phone
(207) 780-0014
Address
68 BISHOP ST., UNIT 1
Deactivation Date
15 November 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1979 (47 years ago)
PAC ID
7113974866
Professional Enrollment ID
I20050405000425
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

  • 68 BISHOP ST., UNIT 1

    SUITE 1

    PORTLAND, ME 041033427

    Phone: (207) 780-0014

    Type: Location

  • 68, Bishop Street, Morrills Corner, Portland, Cumberland County, Maine, 04103, United States

    SUITE 1

    PORTLAND, ME 041032681

    Phone: (207) 780-0014

    Type: Mailing

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)

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 04103)

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Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1013984335 for Unknown Individual, then check state licensing separately.
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 primary classification?
Psychologist is the headline specialty for Unknown Individual here. 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.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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