Unknown Individual – Clinical Psychologist, NPI 1043240138

Unknown Individual is a healthcare provider. based in Mclean, Virginia. specializing in Clinical Psychologist. They hold a License No. 0810001450 (VA). The NPI Number for Unknown Individual is 1043240138

Main info

Organization
Inactive
47 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1043240138
Phone
(703) 790-7279
Address
6832 OLD DOMINION DR
Deactivation Date
13 November 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7037907279
Graduation Year
1979 (47 years ago)
PAC ID
8921296849
Professional Enrollment ID
I20101220000508
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

  • 6832, Old Dominion Drive, Bryn Mawr, Langley, McLean, Fairfax County, Virginia, 22102, United States

    SUITE 200

    MCLEAN, VA 221013887

    Phone: (703) 790-7279

    Fax: (703) 734-0910

    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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90837Psychotherapy, 1 hour26716$0
View full utilization report →

Insurance plans in this area (ZIP 22101)

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Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1043240138.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Mclean, Virginia for Unknown Individual; download NPPES for the complete set.
What if Mclean, Virginia seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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