Unknown Individual – Clinical Psychologist, NPI 1609877513

Unknown Individual is a healthcare provider. based in Lynchburg, Virginia. specializing in Clinical Psychologist. They hold a License No. 0810001078 (VA). The NPI Number for Unknown Individual is 1609877513

Main info

Organization
Inactive
46 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1609877513
Phone
(434) 845-4454
Address
210 ROWLAND DR
Deactivation Date
22 September 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1980 (46 years ago)
PAC ID
8426082926
Professional Enrollment ID
I20050923000696
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

  • 210, Rowland Drive, Lynchburg, Lynchburg (city), Virginia, 24503, United States

    LYNCHBURG, VA 245032618

    Phone: (434) 845-4454

    Fax: (434) 845-4299

    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 24503)

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Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1609877513; it appears in the national provider directory.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
What kind of provider is Unknown Individual?
The page reflects Clinical Psychologist for Unknown Individual. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Lynchburg, Virginia for Unknown Individual; expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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