Unknown Individual – Clinical Psychologist, NPI 1396764163

Unknown Individual is a healthcare provider. based in Fort walton beach, Florida. specializing in Clinical Psychologist. They hold a License No. PY2540 (FL). The NPI Number for Unknown Individual is 1396764163

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1396764163
Phone
(850) 862-3141
Address
235 CARMEL DR
Deactivation Date
26 February 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

Provider Addresses for Unknown Individual

  • 235 CARMEL DR

    FORT WALTON BEACH, FL 325471957

    Phone: (850) 862-3141

    Fax: (850) 862-7732

    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 32547)

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Reviews

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Frequently asked questions

What is the standard ID for Unknown Individual in the U.S.?
In the U.S., Unknown Individual is identified by NPI 1396764163.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
Which specialty label fits Unknown Individual?
NPPES ties Unknown Individual to Clinical Psychologist in the taxonomy section. Clinical services aligned with this taxonomy classification.
Can patients visit Unknown Individual in Fort Walton Beach, Florida?
For routing, start with Fort Walton Beach, Florida for Unknown Individual, then verify phone and hours locally.
Why is information missing for Unknown Individual?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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