Unknown Individual – Clinical Psychologist, NPI 1457413593

Unknown Individual is a healthcare provider. based in Shelburne, Vermont. specializing in Clinical Psychologist. They hold a License No. VT728 (VT). The NPI Number for Unknown Individual is 1457413593

Main info

Organization
Inactive
29 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1457413593
Phone
(802) 651-8999
Address
PO BOX 343
Deactivation Date
23 October 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
80265189992
Graduation Year
1997 (29 years ago)
PAC ID
6103851548
Professional Enrollment ID
I20051004000821
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

  • PO BOX 343

    SHELBURNE, VT 054820343

    Phone: (802) 651-8999

    Fax: (802) 651-8997

    Type: Mailing

  • Dorset Street, South Burlington, Chittenden County, Vermont, 05403, United States

    STE 2

    SOUTH BURLINGTON, VT 054036240

    Phone: (802) 651-8999

    Fax: (802) 651-8997

    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

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.

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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 05482)

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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 1457413593 for Unknown Individual, then check state licensing separately.
Why might Unknown Individual appear inactive while still practicing?
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.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Shelburne, Vermont; more addresses can appear in NPPES.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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