Unknown Individual – Psychologist, NPI 1497754410

Unknown Individual is a healthcare provider. based in Akron, Ohio. specializing in Psychologist. They hold a License No. 3833 (OH). The NPI Number for Unknown Individual is 1497754410

Main info

Organization
Inactive
40 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1497754410
Phone
(330) 644-3469
Address
3469 FORTUNA DR
Deactivation Date
28 July 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3306443469
Graduation Year
1986 (40 years ago)
PAC ID
1850568486
Group Practice PAC ID
1658437389
Professional Enrollment ID
I20120121000085
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

  • 3469 FORTUNA DR

    AKRON, OH 443125281

    Phone: (330) 644-3469

    Fax: (330) 644-8519

    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 44312)

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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: 1658437389View full group profile
NameSpecialtyState
Clinical Social WorkerOH
Clinical Social WorkerOH
Mental Health CounselorOH
Mental Health CounselorOH
Clinical Social WorkerOH
Mental Health CounselorOH
Mental Health CounselorOH
Mental Health CounselorOH
Clinical PsychologistOH
-OH

Reviews

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Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?
Yes. Unknown Individual is listed with NPI 1497754410 in the public NPI dataset.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Psychologist. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Akron, Ohio; more addresses can appear in NPPES.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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