Unknown Individual – Psychologist, NPI 1174572630

Unknown Individual is a healthcare provider. based in Tallahassee, Florida. specializing in Psychologist. They hold a License No. PY0003707 (FL). The NPI Number for Unknown Individual is 1174572630

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1174572630
Phone
(850) 386-3082
Address
2013 E RANDOLPH CIR
Deactivation Date
16 April 2026
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

  • 2013, East Randolph Circle, Tallahassee, Leon County, Florida, 32308, United States

    TALLAHASSEE, FL 323080723

    Phone: (850) 386-3082

    Fax: (850) 385-7978

    Type: Mailing

  • 1235, Miccosukee Road, Tallahassee, Leon County, Florida, 32308, United States

    TALLAHASSEE, FL 323085007

    Phone: (850) 402-1976

    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

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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 ·

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No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32308)

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Reviews

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1174572630.
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 expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Psychologist. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Tallahassee, Florida.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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