Unknown Individual – Clinical Psychologist, NPI 1285695213

Unknown Individual is a healthcare provider. based in Walnutport, Pennsylvania. specializing in Clinical Psychologist. They hold a License No. PS-003514-L (PA). The NPI Number for Unknown Individual is 1285695213

Main info

Organization
Inactive
39 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1285695213
Phone
(610) 799-8358
Address
529 BLUE MOUNTAIN DR
Deactivation Date
2 December 2022

Doctor Profile

Medical School Name
TEMPLE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
6108651303
Graduation Year
1987 (39 years ago)
PAC ID
2860747102
Group Practice PAC ID
3375547946
Professional Enrollment ID
I20180611000428
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:0State licenses:2Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 529 BLUE MOUNTAIN DR

    WALNUTPORT, PA 180889645

    Phone: (610) 799-8358

    Fax: (610) 799-8026

    Type: Mailing

  • 35 E ELIZABETH AVE STE 37

    BETHLEHEM, PA 180186527

    Phone: (610) 799-8358

    Fax: (610) 799-8026

    Type: Location

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.

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Medicare Enrollment & Revalidation

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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)

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No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 18088)

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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: 3375547946View full group profile
NameSpecialtyState
-PA

Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1285695213.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
What type of care does Unknown Individual provide?
Unknown Individual's profile centers on Clinical Psychologist. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Walnutport, Pennsylvania. Check all listed addresses for suites or satellite offices.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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