Unknown Individual – Clinical Child & Adolescent Psychologist, NPI 1669546479

Unknown Individual is a healthcare provider. based in Saint paul, Minnesota. specializing in Clinical Child & Adolescent Psychologist. They hold a License No. 0523 (MN). The NPI Number for Unknown Individual is 1669546479

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1669546479
Phone
(651) 646-7010
Address
570 ASBURY ST
Deactivation Date
26 February 2026
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

  • Asbury Street, Hamline-Midway, Saint Paul, Ramsey County, Minnesota, 55104, United States

    SUITE 310

    SAINT PAUL, MN 551041849

    Phone: (651) 646-7010

    Fax: (651) 646-7668

    Type: Location

  • 32 EAGLES NEST CIR

    HUDSON, WI 540167735

    Phone: (651) 430-2636

    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

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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)

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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 55104)

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Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1669546479; it appears in the national provider directory.
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 Clinical Child & Adolescent Psychologist for Unknown Individual. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface Saint Paul, Minnesota for Unknown Individual based on available NPPES addresses.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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