Unknown Individual – Clinical Psychologist, NPI 1053493635

Unknown Individual is a healthcare provider. based in Hamilton, New Jersey. specializing in Clinical Psychologist. They hold a License No. PS005462-L (PA). The NPI Number for Unknown Individual is 1053493635

Main info

Organization
Inactive
37 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1053493635
Phone
(609) 586-0444
Address
2079 KLOCKNER RD
Deactivation Date
24 April 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6095860444
Graduation Year
1989 (37 years ago)
PAC ID
0547202012
Group Practice PAC ID
4880674654
Professional Enrollment ID
I20050525000096
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

  • 2079;2081, Klockner Road, Creston, Hamilton Township, Mercer County, New Jersey, 08690, United States

    HAMILTON, NJ 086903415

    Phone: (609) 586-0444

    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.

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 08690)

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Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1053493635; it appears in the national provider directory.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Clinical Psychologist. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface Hamilton, New Jersey for Unknown Individual based on available NPPES addresses.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1053493635. Always confirm identity and privileges with the practice and licensing boards.