Unknown Individual – Clinical Psychologist, NPI 1790784841

Unknown Individual is a healthcare provider. based in Eldersburg, Maryland. specializing in Clinical Psychologist. They hold a License No. 2140 (MD). The NPI Number for Unknown Individual is 1790784841

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1790784841
Phone
(410) 795-4764
Address
1645 LIBERTY RD
Deactivation Date
19 July 2023

Contacts

Other Endpoint
Dagsboro
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness85
Years active:0State licenses:2Other namesUpdated within 12 months

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Provider Addresses for Unknown Individual

  • 1645, Liberty Road, Freedom Village, Eldersburg, Carroll County, Maryland, 21784, United States

    SUITE 104

    ELDERSBURG, MD 217846521

    Phone: (410) 795-4764

    Type: Mailing

  • 34400 INDIAN RIVER DR

    DAGSBORO, DE 199393305

    Phone: (410) 227-5388

    Type: Mailing

  • 117 MAIN ST

    MILLSBORO, DE 199668410

    Phone: (302) 396-6086

    Type: Location

  • 1645 Liberty Rd

    Suite 104

    Eldersburg, MD 217846521

    Phone: (410) 795-4764

    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 21784)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1790784841 — is the standard way to identify this listing.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What is Unknown Individual's primary classification?
Clinical Psychologist is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Eldersburg, Maryland in the data we show; additional addresses may exist on the full record.
Why does Unknown Individual have multiple addresses?
5 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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