Unknown Individual – Clinical Psychologist, NPI 1376635284

Unknown Individual is a healthcare provider. based in Ottawa, Kansas. specializing in Clinical Psychologist. They hold a License No. 190 (KS). The NPI Number for Unknown Individual is 1376635284

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1376635284
Phone
Not provided
Address
1246 S CEDAR ST
Deactivation Date
30 January 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

  • 1246, South Cedar Street, Ottawa, Franklin County, Kansas, 66067, United States

    OTTAWA, KS 660673513

    Phone:

    Type: Mailing

  • 204, East 15th Street, Holland, Ottawa County, Michigan, 49423, United States

    OTTAWA, KS 660673903

    Phone: (785) 242-3780

    Fax: (785) 242-6397

    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.

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.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

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 66067)

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Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1376635284 for Unknown Individual, then check state licensing separately.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Clinical Psychologist. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Ottawa, Kansas in our summary view.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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