Unknown Individual – Counseling Psychologist, NPI 1427049980

Unknown Individual is a healthcare provider. based in Joplin, Missouri. specializing in Counseling Psychologist. They hold a License No. 01320 (MO). The NPI Number for Unknown Individual is 1427049980

Main info

Organization
Inactive
42 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1427049980
Phone
(417) 782-1910
Address
2702 CUNNINGHAM AVE
Deactivation Date
19 December 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4177821910
Graduation Year
1984 (42 years ago)
PAC ID
1153568332
Group Practice PAC ID
4688610603
Professional Enrollment ID
I20140414001148
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

  • 2702, South Cunningham Avenue, Joplin, Jasper County, Missouri, 64804, United States

    STE A

    JOPLIN, MO 648041570

    Phone: (417) 782-1910

    Fax: (417) 782-1844

    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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 64804)

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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: 4688610603View full group profile

Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1427049980 if you need a stable reference for Unknown Individual.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
Does Unknown Individual list a primary specialty?
If you are matching referrals, note Counseling Psychologist for Unknown Individual. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Joplin, Missouri for Unknown Individual; expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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