Unknown Individual – Clinical Psychologist, NPI 1295731107

Unknown Individual is a healthcare provider. based in Annapolis, Maryland. specializing in Clinical Psychologist. They hold a License No. 02589 (MD). The NPI Number for Unknown Individual is 1295731107

Main info

Organization
Inactive
38 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1295731107
Phone
(410) 626-1162
Address
133 DEFENSE HWY
Deactivation Date
7 February 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1988 (38 years ago)
PAC ID
4880839240
Professional Enrollment ID
I20130408000179
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

  • 133 DEFENSE HWY

    STE 205

    ANNAPOLIS, MD 214018924

    Phone: (410) 626-1162

    Fax: (410) 266-7663

    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.

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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 21401)

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Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1295731107.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Clinical Psychologist. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Annapolis, Maryland; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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