Unknown Individual – Adult Development & Aging Psychologist, NPI 1164558318

Unknown Individual is a healthcare provider. based in Jamaica plain, Massachusetts. specializing in Adult Development & Aging Psychologist. They hold a License No. 6462 (MA). The NPI Number for Unknown Individual is 1164558318

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1164558318
Phone
(617) 524-7290
Address
14 PARK LN
Deactivation Date
22 January 2026
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 14 PARK LN

    JAMAICA PLAIN, MA 021302906

    Phone: (617) 524-7290

    Fax: (617) 524-7290

    Type: Mailing

  • 256 CONCORD AVE

    CAMBRIDGE, MA 021381337

    Phone: (617) 864-4220

    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 02130)

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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 1164558318 for Unknown Individual, then check state licensing separately.
Is Unknown Individual excluded from programs when inactive?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Adult Development & Aging Psychologist. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Jamaica Plain, Massachusetts may find Unknown Individual in results; validate coverage separately.
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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