Unknown Individual – Clinical Psychologist, NPI 1922161686

Unknown Individual is a healthcare provider. based in Portland, Maine. specializing in Clinical Psychologist. They hold a License No. PSY712 (ME). The NPI Number for Unknown Individual is 1922161686

Main info

Organization
Inactive
38 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1922161686
Phone
(207) 772-1164
Address
178 MIDDLE ST
Deactivation Date
8 May 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1988 (38 years ago)
PAC ID
0446322846
Professional Enrollment ID
I20080911000332
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 178, Middle Street, Old Port, Downtown, Portland, Cumberland County, Maine, 04101, United States

    SUITE 300

    PORTLAND, ME 041014075

    Phone: (207) 772-1164

    Fax: (207) 772-2670

    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 04101)

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Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1922161686 on file in the registry.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Portland?
Public fields place Unknown Individual around Portland, Maine. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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