Unknown Individual – Psychologist, NPI 1184638314

Unknown Individual is a healthcare provider. based in Waban, Massachusetts. specializing in Psychologist. They hold a License No. 2567 (MA). The NPI Number for Unknown Individual is 1184638314

Main info

Organization
Inactive
47 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1184638314
Phone
(781) 320-9680
Address
PO BOX 38
Deactivation Date
31 July 2024

Doctor Profile

Medical School Name
BOSTON UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
7814533000
Graduation Year
1979 (47 years ago)
PAC ID
9234397530
Professional Enrollment ID
I20120215000816
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 38

    WABAN, MA 024680001

    Phone: (781) 320-9680

    Fax: (781) 329-6929

    Type: Mailing

  • New England Baptist Hospital, 125, Parker Hill Avenue, Roxbury, Boston, Suffolk County, Massachusetts, 02120, United States

    ROXBURY CROSSING, MA 021202847

    Phone: (781) 320-9680

    Fax: (781) 329-6929

    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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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 02468)

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Reviews

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1184638314.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Psychologist in the directory — Clinical services aligned with this taxonomy classification.
Where in Massachusetts is Unknown Individual registered?
Use Waban, Massachusetts as the headline location for Unknown Individual here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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