Unknown Individual – Clinical Psychologist, NPI 1245259704

Unknown Individual is a healthcare provider. based in Palm coast, Florida. specializing in Clinical Psychologist. They hold a License No. PY6129 (FL). The NPI Number for Unknown Individual is 1245259704

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1245259704
Phone
(386) 586-3969
Address
15 CYPRESS BRANCH WAY
Deactivation Date
19 March 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

  • 15, Cypress Branch Way, Palm Coast, Flagler County, Florida, 32164, United States

    SUITE 207-C

    PALM COAST, FL 321648413

    Phone: (386) 586-3969

    Type: Location

  • 68, Egret Trail, Palm Coast, Flagler County, Florida, 32164, United States

    PALM COAST, FL 321646263

    Phone: (386) 586-3969

    Type: Mailing

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 ·

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 32164)

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Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1245259704 as the unique 10-digit identifier.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Clinical Psychologist. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Palm Coast, Florida.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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