Unknown Individual – Clinical Psychologist, NPI 1932106606

Unknown Individual is a healthcare provider. based in Mankato, Minnesota. specializing in Clinical Psychologist. They hold a License No. LP2831 (MN). The NPI Number for Unknown Individual is 1932106606

Main info

Organization
Inactive
44 Years Of Experience
Name
Unknown Individual
NPI
1932106606
Phone
(507) 779-7366
Address
1400 MADISON AVE STE 628
Deactivation Date
3 May 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5077797366
Graduation Year
1982 (44 years ago)
PAC ID
1052209863
Group Practice PAC ID
7214003680
Professional Enrollment ID
I20100927000463
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

Loading map...

Provider Addresses for Unknown Individual

  • 628, Madison Avenue, Mankato, Blue Earth County, Minnesota, 56001, United States

    MANKATO, MN 560015488

    Phone: (507) 779-7366

    Fax: (855) 847-9876

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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.

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90837Psychotherapy, 1 hour8822$0
View full utilization report →

Insurance plans in this area (ZIP 56001)

Loading plans...

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: 7214003680View full group profile
NameSpecialtyState
Mental Health CounselorMN
-MN
Mental Health CounselorMN
Clinical Social WorkerMN
Clinical PsychologistMN
Clinical Social WorkerMN
Mental Health CounselorMN
Mental Health CounselorMN
Marriage And Family TherapistMN
Clinical PsychologistMN

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

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 1932106606.
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 Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Mankato, Minnesota?
If you are local to Mankato, Minnesota, 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.

Similar Providers

410, South 5th Street, Mankato, Blue Earth County, Minnesota, 56001, United States
NPI: 1396729703

LISA R HARDESTY (PHD)

Clinical Psychologist
Mayo Clinic Health System, 1025, Marsh Street, High Ciara, Mankato, Blue Earth County, Minnesota, 56001, United States
NPI: 1154305126

THERESA L GUNDERSON (PHD)

Clinical Psychologist
Mankato Post Office, East Main Street, Mankato, Blue Earth County, Minnesota, 56001, United States
NPI: 1043298060

STEVEN P PETERSON (MS, LP)

Clinical Psychologist
Mankato Post Office, East Main Street, Mankato, Blue Earth County, Minnesota, 56001, United States
NPI: 1326027244
Mankato Post Office, East Main Street, Mankato, Blue Earth County, Minnesota, 56001, United States
NPI: 1831178136

ANGELA L H BUFFINGTON (PHD LP)

Clinical Neuropsychologist
101 Martin Luther King Dr
NPI: 1790751832

PATRICIA R GUSTAFSON (MS LP)

Clinical Psychologist
Mankato Post Office, East Main Street, Mankato, Blue Earth County, Minnesota, 56001, United States
NPI: 1710943840

DR. THEODORE SURDY (PHD LP)

Clinical Psychologist
16200 560TH LN
NPI: 1063463347