Unknown Individual – Clinical Psychologist, NPI 1164577037

Unknown Individual is a healthcare provider. based in Fairbanks, Alaska. specializing in Clinical Psychologist. They hold a License No. AA371 (AK). The NPI Number for Unknown Individual is 1164577037

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1164577037
Phone
(907) 457-4614
Address
688 CHENA RIDGE RD
Deactivation Date
30 August 2025
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

  • 688, Chena Ridge Road, Broadmoor, Fairbanks North Star Borough, Alaska, 99709, United States

    FAIRBANKS, AK 997092403

    Phone: (907) 457-4614

    Fax: (907) 457-4614

    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

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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 99709)

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Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1164577037 as the unique 10-digit identifier.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Clinical Psychologist. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Fairbanks, Alaska.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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