Unknown Individual – Psychologist, NPI 1841320975

Psychologist

Unknown Individual is a healthcare provider. based in Warren, Michigan. specializing in Psychologist. They hold a License No. 6301000678 (MI). The NPI Number for Unknown Individual is 1841320975

Main info

Organization

Inactive

60 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1841320975

Phone

(586) 755-9855

Address

27423 VAN DYKE AVE

Deactivation Date

14 June 2022

Doctor Profile

Medical School Name

VANDERBILT UNIVERSITY SCHOOL OF MEDICINE

Secondary Phone

5869839280

Graduation Year

1966 (60 years ago)

PAC ID

2163526484

Group Practice PAC ID

7214249424

Professional Enrollment ID

I20070327000197

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

Provider Addresses for Unknown Individual

27423 VAN DYKE AVE
WARREN, MI 480932867
Phone: (586) 755-9855
Fax: (586) 755-9880
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 48093)

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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: 7214249424View full group profile

Name	Specialty	State
DANIEL DEVRIES	P S Y C H I A T R Y	MI
DR. HAITHAM A SAFO (LPC)	Mental Health Counselor	MI
TARA PITTMAN (LMSW)	Clinical Social Worker	MI

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 1841320975 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.

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 geographic area is tied to Unknown Individual?

Unknown Individual is associated with Warren, Michigan in the same public data insurers reference.

Who maintains Unknown Individual's record?

Providers certify NPPES data; CMS hosts the public file you are viewing.