Unknown Individual – Counseling Psychologist, NPI 1821172925

Unknown Individual is a healthcare provider. based in Eagan, Minnesota. specializing in Counseling Psychologist. They hold a License No. LP1015 (MN). The NPI Number for Unknown Individual is 1821172925

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1821172925
Phone
(651) 688-3504
Address
4147 RUBY LANE
Deactivation Date
15 September 2021
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

  • 4147, Ruby Lane, Diffley Commons, Eagan, Dakota County, Minnesota, 55122, United States

    EAGAN, MN 55122

    Phone: (651) 688-3504

    Mailing address matches the actual address.

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.

This can happen when there are no reportable CMS Open Payments records.

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.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

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 55122)

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Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1821172925 for Unknown Individual.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Counseling Psychologist. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Eagan, Minnesota in the same public data insurers reference.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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