Unknown Individual – Psychologist, NPI 1003030511

Unknown Individual is a healthcare provider. based in Laramie, Wyoming. specializing in Psychologist. They hold a License No. 291 (WY). The NPI Number for Unknown Individual is 1003030511

Main info

Organization
Inactive
36 Years Of Experience
Name
Unknown Individual
NPI
1003030511
Phone
(307) 755-1982
Address
507 S 4TH ST
Deactivation Date
4 September 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1990 (36 years ago)
PAC ID
7113237447
Professional Enrollment ID
I20151117000805
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 507 S 4TH ST

    SUITE B

    LARAMIE, WY 820703729

    Phone: (307) 755-1982

    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.

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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 82070)

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Reviews

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Frequently asked questions

What is Unknown Individual's NPI number?
Unknown Individual's NPI is 1003030511 — the number used across U.S. healthcare to identify this provider.
Is Unknown Individual still active if the NPI shows inactive?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Psychologist in the directory — Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Laramie, Wyoming as the reference point for Unknown Individual, then confirm.
What does 2 location(s) imply?
2 practice locations appear in the available data.