Unknown Individual – Psychologist, NPI 1033125521

Unknown Individual is a healthcare provider. based in Lees summit, Missouri. specializing in Psychologist. They hold a License No. 01402 (MO). The NPI Number for Unknown Individual is 1033125521

Main info

Organization
Inactive
41 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1033125521
Phone
(816) 524-5818
Address
409 SE DOUGLAS ST
Deactivation Date
28 August 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1985 (41 years ago)
PAC ID
5890989545
Professional Enrollment ID
I20101027000564
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

  • 409, Southeast Douglas Street, Lee's Summit, Jackson County, Missouri, 64063, United States

    LEES SUMMIT, MO 640634246

    Phone: (816) 524-5818

    Fax: (816) 524-5819

    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.

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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.

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90837Psychotherapy, 1 hour45344$0
90791Psychiatric diagnostic evaluation1918$0
View full utilization report →

Insurance plans in this area (ZIP 64063)

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Reviews

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Frequently asked questions

What is Unknown Individual's NPI number?
Unknown Individual's NPI is 1033125521 — the number used across U.S. healthcare to identify this provider.
Is Unknown Individual still active if the NPI shows inactive?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Psychologist. Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Lees Summit?
Unknown Individual currently maps to Lees Summit, Missouri in this extract.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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