Unknown Individual – Clinical Psychologist, NPI 1407961378

Unknown Individual is a healthcare provider. based in Ft lauderdale, Florida. specializing in Clinical Psychologist. They hold a License No. PY4173 (FL). The NPI Number for Unknown Individual is 1407961378

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1407961378
Phone
(954) 522-4941
Address
1700 SW 22ND ST
Deactivation Date
21 March 2022
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

  • 1700, Southwest 22nd Street, Fort Lauderdale, Broward County, Florida, 33315, United States

    FT LAUDERDALE, FL 333151837

    Phone: (954) 522-4941

    Fax: (954) 522-4357

    Type: Mailing

  • 2101, South Andrews Avenue, Fort Lauderdale, Broward County, Florida, 33316, United States

    SUITE #105

    FT LAUDERDALE, FL 333163468

    Phone: (954) 522-4941

    Fax: (954) 522-4357

    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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No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

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

Insurance plans in this area (ZIP 33315)

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Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1407961378 on file in the registry.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Ft Lauderdale?
Public fields place Unknown Individual around Ft Lauderdale, Florida. Always confirm the exact site before visiting.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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