Unknown Individual – Clinical Psychologist, NPI 1942249974

Unknown Individual is a healthcare provider. based in West bloomfield, Michigan. specializing in Clinical Psychologist. They hold a License No. 007740 (MI). The NPI Number for Unknown Individual is 1942249974

Main info

Organization
Inactive
30 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1942249974
Phone
(248) 626-1500
Address
6960 ORCHARD LAKE RD
Deactivation Date
1 November 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2486261500
Graduation Year
1996 (30 years ago)
PAC ID
7214992353
Group Practice PAC ID
0648225664
Professional Enrollment ID
I20041130000840
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Orchard Lake Road, West Bloomfield Township, Oakland County, Michigan, 48334, United States

    SUITE 100

    WEST BLOOMFIELD, MI 483224515

    Phone: (248) 626-1500

    Fax: (248) 626-1551

    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 48322)

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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: 0648225664View full group profile
NameSpecialtyState
-MI
Clinical Social WorkerMI
Clinical Social WorkerMI
-MI
Clinical Social WorkerMI
-MI
Clinical PsychologistMI
Clinical Social WorkerMI
Clinical Social WorkerMI
Clinical Social WorkerMI

Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1942249974; it appears in the national provider directory.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What kind of provider is Unknown Individual?
The page reflects Clinical Psychologist for Unknown Individual. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface West Bloomfield, Michigan for Unknown Individual based on available NPPES addresses.
How can I contact Unknown Individual?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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