Unknown Individual – Health Service Psychologist, NPI 1356415079

Unknown Individual is a healthcare provider. based in Worcester, Massachusetts. specializing in Health Service Psychologist. They hold a License No. 2277 (MA). The NPI Number for Unknown Individual is 1356415079

Main info

Organization
Inactive
48 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1356415079
Phone
(508) 754-0398
Address
390 MAIN ST
Deactivation Date
30 April 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9785374920
Graduation Year
1978 (48 years ago)
PAC ID
9830353101
Professional Enrollment ID
I20120618000354
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

  • 390, Main Street, West Rutland, Rutland, Worcester County, Massachusetts, 01543, United States

    SUITE 547

    WORCESTER, MA 016082583

    Phone: (508) 754-0398

    Type: Location

  • 14, Stagecoach Road, Leominster, Worcester County, Massachusetts, 01453-3312, United States

    LEOMINSTER, MA 014533472

    Phone: (978) 537-4920

    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 01608)

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Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1356415079.
What dates should I check for Unknown Individual's activity?
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 Health Service Psychologist. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Worcester, Massachusetts as a primary anchor for Unknown Individual unless the record lists multiple sites.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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