Unknown Individual – Clinical Psychologist, NPI 1861569162

Unknown Individual is a healthcare provider. based in Wayland, Massachusetts. specializing in Clinical Psychologist. They hold a License No. 926 (MA). The NPI Number for Unknown Individual is 1861569162

Main info

Organization
Inactive
66 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1861569162
Phone
(508) 358-5918
Address
17 CAMERON RD
Deactivation Date
19 March 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5083585918
Graduation Year
1960 (66 years ago)
PAC ID
0143375501
Professional Enrollment ID
I20090908000663
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

  • 17, Cameron Road, Wayland, Middlesex County, Massachusetts, 01778, United States

    WAYLAND, MA 017783101

    Phone: (508) 358-5918

    Fax: (309) 419-7419

    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.

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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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90837Psychotherapy, 1 hour36613$0
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Insurance plans in this area (ZIP 01778)

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Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1861569162 for Unknown Individual.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
How should patients interpret Unknown Individual's specialty?
The extract shows Clinical Psychologist for Unknown Individual. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Wayland, Massachusetts in the same public data insurers reference.
Why is information missing for Unknown Individual?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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