Unknown Individual – Psychologist, NPI 1962518456

Unknown Individual is a healthcare provider. based in Medford, Massachusetts. specializing in Psychologist. They hold a License No. 6371 (MA). The NPI Number for Unknown Individual is 1962518456

Main info

Organization
Inactive
35 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1962518456
Phone
(781) 396-1199
Address
151 MYSTIC AVE
Deactivation Date
18 November 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7818716550
Graduation Year
1991 (35 years ago)
PAC ID
6305739269
Group Practice PAC ID
0749192656
Professional Enrollment ID
I20040204000755
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

  • 151, Mystic Avenue, Medford, Middlesex County, Massachusetts, 02155, United States

    MEDFORD, MA 021554632

    Phone: (781) 396-1199

    Fax: (781) 396-1439

    Type: Location

  • Hyannis Post Office, 385, Main Street, Hyannis, Barnstable, Barnstable County, Massachusetts, 02601, United States

    HYANNIS, MA 026017358

    Phone: (508) 778-4241

    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.

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02155)

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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: 0749192656View full group profile

Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1962518456.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What does the directory say Unknown Individual does?
Insurance directories may phrase it differently, but here Unknown Individual maps to Psychologist. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Medford, Massachusetts. Check all listed addresses for suites or satellite offices.
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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