Unknown Individual – Psychologist, NPI 1407966583

Psychologist

Unknown Individual is a healthcare provider. based in Andover, Massachusetts. specializing in Psychologist. They hold a License No. 2238 (MA). The NPI Number for Unknown Individual is 1407966583

Main info

Organization

Inactive

57 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1407966583

Phone

(978) 475-6622

Address

3 DUNDEE PARK

Deactivation Date

12 April 2023

Doctor Profile

Medical School Name

OTHER

Secondary Phone

9784756622

Graduation Year

1969 (57 years ago)

PAC ID

7810020765

Professional Enrollment ID

I20100729000685

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

3, Dundee Park, Andover, Essex County, Massachusetts, 01810, United States
STE B05
ANDOVER, MA 018103743
Phone: (978) 475-6622
Fax: (978) 475-8436
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.

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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.

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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 01810)

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Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?

Public records show Unknown Individual under NPI 1407966583.

What should I verify if Unknown Individual is listed inactive?

If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.

Which specialty label fits Unknown Individual?

NPPES ties Unknown Individual to Psychologist in the taxonomy section. Clinical services aligned with this taxonomy classification.

Can patients visit Unknown Individual in Andover, Massachusetts?

For routing, start with Andover, Massachusetts for Unknown Individual, then verify phone and hours locally.

What is the difference between NPI and a medical license?

An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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