Unknown Individual – Clinical Psychologist, NPI 1568438497

Unknown Individual is a healthcare provider. based in Lebanon, Ohio. specializing in Clinical Psychologist. They hold a License No. 3444 (OH). The NPI Number for Unknown Individual is 1568438497

Main info

Organization
Inactive
44 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1568438497
Phone
(513) 228-7800
Address
975 KINGSIVEW DRIVE
Deactivation Date
31 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5136952556
Graduation Year
1982 (44 years ago)
PAC ID
7719882612
Group Practice PAC ID
0446155337
Professional Enrollment ID
I20040804000071
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

  • 975 KINGSIVEW DRIVE

    BLDG A

    LEBANON, OH 450369562

    Phone: (513) 228-7800

    Fax: (513) 228-7846

    Type: Location

  • 953 S South St

    Wilmington, OH 451772921

    Phone: (937) 383-4441

    Fax: (937) 383-2916

    Type: Location

  • 204, Cook Road, Lebanon, Warren County, Ohio, 45036, United States

    SUITE 400

    LEBANON, OH 450369600

    Phone: (513) 228-7800

    Fax: (513) 725-2231

    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 45036)

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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: 0446155337View full group profile

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 1568438497 in the public NPI dataset.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Lebanon, 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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