Unknown Individual – Psychologist, NPI 1306903125

Unknown Individual is a healthcare provider. based in Worcester, Massachusetts. specializing in Psychologist. They hold a License No. 1496 (MA). The NPI Number for Unknown Individual is 1306903125

Main info

Organization
Inactive
52 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1306903125
Phone
(508) 791-5777
Address
14 HUNTHURST CIR
Deactivation Date
3 April 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5087535425
Graduation Year
1974 (52 years ago)
PAC ID
8729156302
Group Practice PAC ID
7911916093
Professional Enrollment ID
I20081009000248
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

  • 14, Hunthurst Circle, Mill Street, Tatnuck Square, Worcester, Worcester County, Massachusetts, 01602, United States

    WORCESTER, MA 016022831

    Phone: (508) 791-5777

    Fax: (508) 791-5777

    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 01602)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7911916093View full group profile

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 1306903125.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Psychologist. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Worcester?
Public fields place Unknown Individual around Worcester, Massachusetts. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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