Unknown Individual – Clinical Psychologist, NPI 1780797985

Clinical Psychologist

Unknown Individual is a healthcare provider. based in Arlington, Texas. specializing in Clinical Psychologist. They hold a License No. 23795 (TX). The NPI Number for Unknown Individual is 1780797985

Main info

Organization

Inactive

38 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1780797985

Phone

(817) 461-6183

Address

902 W MITCHELL ST

Deactivation Date

27 November 2025

Doctor Profile

Medical School Name

OTHER

Secondary Phone

8174297546

Graduation Year

1988 (38 years ago)

PAC ID

9638224264

Professional Enrollment ID

I20090903000663

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

902, West Mitchell Street, Arlington, Tarrant County, Texas, 76013, United States
ARLINGTON, TX 760132537
Phone: (817) 461-6183
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 76013)

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Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?

You can start verification with NPI 1780797985 for Unknown Individual, then check state licensing separately.

Why is Unknown Individual marked inactive in the NPI directory?

The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.

What taxonomy line describes Unknown Individual?

For research purposes, treat Unknown Individual as Clinical Psychologist in this dataset. Clinical services aligned with this taxonomy classification.

Where should I expect Unknown Individual on a map?

Expect Arlington, Texas 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.