Unknown Individual – Clinical Psychologist, NPI 1093751208

Unknown Individual is a healthcare provider. based in Braintree, Massachusetts. specializing in Clinical Psychologist. They hold a License No. 777 (MA). The NPI Number for Unknown Individual is 1093751208

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1093751208
Phone
(781) 248-8357
Address
639 GRANITE ST
Deactivation Date
5 June 2025
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

  • Eda's Cafe, 639, Granite Street, Five Corners, Braintree, Norfolk County, Massachusetts, 02184, United States

    SUITE LL15

    BRAINTREE, MA 021845366

    Phone: (781) 248-8357

    Fax: (781) 659-2419

    Type: Location

  • 67, Central Street, Norwell, Plymouth County, Massachusetts, 02061, United States

    NORWELL, MA 020611307

    Phone: (781) 248-8357

    Fax: (781) 659-2419

    Type: Mailing

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 02184)

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Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1093751208.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Braintree, Massachusetts may find Unknown Individual in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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