Unknown Individual – Psychologist, NPI 1063591568

Unknown Individual is a healthcare provider. based in Lowell, Massachusetts. specializing in Psychologist. They hold a License No. 01246 (MA). The NPI Number for Unknown Individual is 1063591568

Main info

Organization
Inactive
50 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1063591568
Phone
(978) 459-2306
Address
81 BRIDGE ST
Deactivation Date
15 March 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2036105814
Graduation Year
1976 (50 years ago)
PAC ID
6709804347
Professional Enrollment ID
I20051102000968
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

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Provider Addresses for Unknown Individual

  • 81;95, Bridge Street, Centralville, Lowell, Middlesex County, Massachusetts, 01852-9998, United States

    SUITE 215

    LOWELL, MA 018521270

    Phone: (978) 459-2306

    Fax: (978) 453-9394

    Type: Location

  • 91, Concord Road, East Acton, Acton, Middlesex County, Massachusetts, 01720, United States

    ACTON, MA 01720

    Phone: (978) 263-8256

    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

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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)

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No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 01852)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1063591568 — is the standard way to identify this listing.
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.
Where is Unknown Individual based?
Unknown Individual is tied to Lowell, Massachusetts in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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