Unknown Individual – Psychiatry Physician, NPI 1134290638

Unknown Individual is a healthcare provider. based in North adams, Massachusetts. specializing in Psychiatry Physician. They hold a License No. 42-0008895 (VT). The NPI Number for Unknown Individual is 1134290638

Main info

Organization
Inactive
58 Years Of Experience
Name
Unknown Individual
NPI
1134290638
Phone
(413) 663-7796
Address
PO BOX 787
Deactivation Date
16 January 2025

Doctor Profile

Medical School Name
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO SCHOOL OF MEDICINE
Secondary Phone
4132818791
Graduation Year
1968 (58 years ago)
PAC ID
2163496001
Professional Enrollment ID
I20050426001045
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

  • PO BOX 787

    NORTH ADAMS, MA 012470787

    Phone: (413) 663-7796

    Fax: (413) 663-9452

    Type: Mailing

  • 82, Elm Street, Bourne Brook, Manchester Center, Manchester, Bennington County, Vermont, 05255, United States

    MANCHESTER CENTER, VT 052559642

    Phone: (413) 281-8791

    Fax: (866) 686-8033

    Type: Location

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)

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 01247)

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Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1134290638.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
Does Unknown Individual list a primary specialty?
If you are matching referrals, note Psychiatry Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes North Adams, Massachusetts for Unknown Individual; expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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