Unknown Individual – Clinical Psychologist, NPI 1487868899

Unknown Individual is a healthcare provider. based in Springfield, Missouri. specializing in Clinical Psychologist. They hold a License No. 2007030433 (MO). The NPI Number for Unknown Individual is 1487868899

Main info

Organization
Inactive
28 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1487868899
Phone
(417) 761-5850
Address
1350 E BRADFORD PKWY
Deactivation Date
12 March 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4177615000
Graduation Year
1998 (28 years ago)
PAC ID
7618036641
Group Practice PAC ID
4486548625
Professional Enrollment ID
I20081106000132
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

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Provider Addresses for Unknown Individual

  • 1350, East Bradford Parkway, Springfield, Greene County, Missouri, 65804, United States

    SPRINGFIELD, MO 658044376

    Phone: (417) 761-5850

    Type: Location

  • Burrell Behavioral Health, 1300, East Bradford Parkway, Springfield, Greene County, Missouri, 65804, United States

    SPRINGFIELD, MO 658044264

    Phone: (417) 761-5000

    Fax: (417) 761-5065

    Type: Mailing

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 65804)

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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: 4486548625View full group profile
NameSpecialtyState
Mental Health CounselorMO
P S Y C H I A T R YMO
Mental Health CounselorMO
Psychiatry, NeuropsychiatryMO
-TX
-MO
-MO
Mental Health CounselorMO
Clinical PsychologistMO
Clinical PsychologistMO

Reviews

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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 1487868899.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
Which specialty label fits Unknown Individual?
NPPES ties Unknown Individual to Clinical Psychologist in the taxonomy section. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Springfield, Missouri. Check all listed addresses for suites or satellite offices.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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