Unknown Individual – Psychologist, NPI 1710023684

Unknown Individual is a healthcare provider. based in Philadelphia, Pennsylvania. specializing in Psychologist. They hold a License No. PS008590L (PA). The NPI Number for Unknown Individual is 1710023684

Main info

Organization
Inactive
35 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1710023684
Phone
Not provided
Address
2200 MICHENER ST STE 20
Deactivation Date
5 December 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2153313200
Graduation Year
1991 (35 years ago)
PAC ID
0143489336
Group Practice PAC ID
8628982386
Professional Enrollment ID
I20120307000555
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

  • 2200 MICHENER ST STE 20

    PHILADELPHIA, PA 191154374

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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 19115)

Loading plans...

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: 8628982386View full group profile
NameSpecialtyState
P S Y C H I A T R YNJ
Clinical Social WorkerPA
Clinical Social WorkerPA
P S Y C H I A T R YPA
Mental Health CounselorPA
Mental Health CounselorPA
Clinical PsychologistPA

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What is the standard ID for Unknown Individual in the U.S.?
In the U.S., Unknown Individual is identified by NPI 1710023684.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Psychologist. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Philadelphia, Pennsylvania?
If you are local to Philadelphia, Pennsylvania, Unknown Individual may be relevant to your search.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

Similar Providers

Unknown Individual

Clinical Psychologist
1048, Yerkes Road, Davisville, Upper Southampton Township, Bucks County, Pennsylvania, 18966, United States
NPI: 1285632802
2200, Benjamin Franklin Parkway, Spring Garden, Philadelphia, Philadelphia County, Pennsylvania, 19130, United States
NPI: 1649271719

THE CENTER FOR AUTISM

Mental Health Counselor
3905, Ford Road, Wynnefield Heights, Philadelphia, Philadelphia County, Pennsylvania, 19131, United States
NPI: 1003808106
Medical Tower Pharmacy, 255, South 17th Street, Rittenhouse Square, Philadelphia, Philadelphia County, Pennsylvania, 19103, United States
NPI: 1790777639
9981, Wistaria Street, Pauls Run, Philadelphia, Philadelphia County, Pennsylvania, 19115, United States
NPI: 1770575151
Icon Apartments, 1616, Walnut Street, Rittenhouse Square, Philadelphia, Philadelphia County, Pennsylvania, 19104, United States
NPI: 1467446625
2450, West Hunting Park Avenue, Tioga, Philadelphia, Philadelphia County, Pennsylvania, 19129, United States
NPI: 1811985021
3509 N Broad St
NPI: 1245228360