Unknown Individual – Clinical Psychologist, NPI 1306836523

Unknown Individual is a healthcare provider. based in Columbus, Ohio. specializing in Clinical Psychologist. They hold a License No. 2359 (OH). The NPI Number for Unknown Individual is 1306836523

Main info

Organization
Inactive
54 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1306836523
Phone
(614) 488-6285
Address
1971 W 5TH AVE
Deactivation Date
30 January 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6144886285
Graduation Year
1972 (54 years ago)
PAC ID
6800927435
Group Practice PAC ID
2567353824
Professional Enrollment ID
I20100626000050
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

  • 1971, West 5th Avenue, Upper Arlington Historic District, Fifth by Northwest, Marble Cliff, Franklin County, Ohio, 43212, United States

    SUITE 2

    COLUMBUS, OH 432121905

    Phone: (614) 488-6285

    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 43212)

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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: 2567353824View full group profile
NameSpecialtyState
BARB TEWART-DARWIN (LISW)
-OH
MICHAEL BRICKEY (PH D)
-OH
JOHN M SHOWALTER (PHD)
-OH
MRS. PEGGY LEWIS (LISW)
-OH

Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1306836523.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Columbus, Ohio as a primary anchor for Unknown Individual unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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