Unknown Individual – Clinical Psychologist, NPI 1902880412

Unknown Individual is a healthcare provider. based in Nevada, Missouri. specializing in Clinical Psychologist. They hold a License No. 2000159804 (MO). The NPI Number for Unknown Individual is 1902880412

Main info

Organization
Inactive
27 Years Of Experience
Name
Unknown Individual
NPI
1902880412
Phone
(417) 667-8700
Address
100 S PREWITT ST
Deactivation Date
15 May 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1999 (27 years ago)
PAC ID
9537268941
Professional Enrollment ID
I20070626000733
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

Provider Addresses for Unknown Individual

  • 100 S PREWITT ST

    NEVADA, MO 647721760

    Phone: (417) 667-8700

    Fax: (417) 667-7382

    Type: Mailing

  • 320 N 14th St

    Rich Hill, MO 647792145

    Phone: (417) 395-2727

    Fax: (816) 884-2923

    Type: Location

  • 100 S Prewitt St

    Nevada, MO 647721760

    Phone: (417) 667-8700

    Fax: (417) 667-7382

    Type: Location

  • 401 N INDEPENDENCE ST

    HARRISONVILLE, MO 647011713

    Phone: (816) 884-2900

    Fax: (816) 884-2923

    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.

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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
90834Psychotherapy, 45 minutes17211$0
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Insurance plans in this area (ZIP 64772)

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Reviews

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Frequently asked questions

What is Unknown Individual's NPI number?
Unknown Individual's NPI is 1902880412 — the number used across U.S. healthcare to identify this provider.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Clinical Psychologist. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Nevada, Missouri as the reference point for Unknown Individual, then confirm.
Can I trust this NPI listing for Unknown Individual?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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