Unknown Individual – Clinical Psychologist, NPI 1164581385

Unknown Individual is a healthcare provider. based in Mt pleasant, Michigan. specializing in Clinical Psychologist. They hold a License No. 6301007695 (MI). The NPI Number for Unknown Individual is 1164581385

Main info

Organization
Inactive
41 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1164581385
Phone
(989) 779-8999
Address
201 S UNIVERSITY AVE
Deactivation Date
17 January 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9897798999
Graduation Year
1985 (41 years ago)
PAC ID
8224093380
Group Practice PAC ID
7719942879
Professional Enrollment ID
I20041230000170
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

  • 201, South University Avenue, Downtown Mount Pleasant, Mount Pleasant, Isabella County, Michigan, 48858, United States

    SUITE 4

    MT PLEASANT, MI 488582527

    Phone: (989) 779-8999

    Fax: (989) 779-2219

    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 48858)

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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: 7719942879View full group profile
NameSpecialtyState
JAMES I GERHART (PH.D.)
-IL
MRS. DONNA MARY RONAN (PHD)
-MI
WILLIAM EDWARD BROWN (LMSW)
-MI

Reviews

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Frequently asked questions

What is the standard ID for Unknown Individual in the U.S.?
In the U.S., Unknown Individual is identified by NPI 1164581385.
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.
Is Unknown Individual tied to Mt Pleasant, Michigan?
If you are local to Mt Pleasant, Michigan, Unknown Individual may be relevant to your search.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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