Unknown Individual – Psychologist, NPI 1154579035

Unknown Individual is a healthcare provider. based in Atlanta, Georgia. specializing in Psychologist. They hold a License No. 537 (MA). The NPI Number for Unknown Individual is 1154579035

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1154579035
Phone
(404) 624-9624
Address
872 E CONFEDERATE AVE SE
Deactivation Date
24 April 2025
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience33
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 872 E CONFEDERATE AVE SE

    ATLANTA, GA 303162537

    Phone: (404) 624-9624

    Fax: (404) 624-3839

    Type: Mailing

  • 741, Piedmont Avenue Northeast, Sweet Auburn, Atlanta, Georgia, 30303, United States

    FIRST FLOOR

    ATLANTA, GA 303081464

    Phone: (404) 624-9624

    Fax: (404) 624-3839

    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

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 30316)

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Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1154579035 if you need a stable reference for Unknown Individual.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
What kind of provider is Unknown Individual?
The page reflects Psychologist for Unknown Individual. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Atlanta, Georgia for Unknown Individual; download NPPES for the complete set.
What if Atlanta, Georgia seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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