Unknown Individual – Group Psychotherapy Psychologist, NPI 1700987039

Unknown Individual is a healthcare provider. based in Minneapolis, Minnesota. specializing in Group Psychotherapy Psychologist. They hold a License No. LP3621 (MN). The NPI Number for Unknown Individual is 1700987039

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1700987039
Phone
(612) 825-9994
Address
306 BUSCH TER
Deactivation Date
25 December 2025
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

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Provider Addresses for Unknown Individual

  • 306, Busch Terrace, Tangletown, Southwest, Minneapolis, Hennepin County, Minnesota, 55419, United States

    MINNEAPOLIS, MN 554195426

    Phone: (612) 825-9994

    Fax: (612) 624-0207

    Type: Mailing

  • 2431, Hennepin Avenue South, Lowry Hill East, Calhoun Isles, Minneapolis, Hennepin County, Minnesota, 55405, United States

    MINNEAPOLIS, MN 554052605

    Phone: (612) 746-8542

    Fax: (612) 374-3323

    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

Source: CMS public data · Not endorsed by CMS ·

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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 55419)

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Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1700987039 on file in the registry.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Group Psychotherapy Psychologist. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Minneapolis, Minnesota.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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