Unknown Individual – Psychologist, NPI 1790722502

Unknown Individual is a healthcare provider. based in Raytown, Missouri. specializing in Psychologist. They hold a License No. 00115 (MO). The NPI Number for Unknown Individual is 1790722502

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1790722502
Phone
(816) 356-6038
Address
9116 E 83RD ST
Deactivation Date
17 May 2023
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

  • 9116, East 83rd Street, Raytown, Jackson County, Missouri, 64138, United States

    RAYTOWN, MO 641383208

    Phone: (816) 356-6038

    Type: Mailing

  • 6704, Raytown Road, Raytown, Jackson County, Missouri, 64133, United States

    RAYTOWN, MO 641335242

    Phone: (816) 356-8888

    Fax: (816) 356-8789

    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.

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 64138)

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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 1790722502.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What is Unknown Individual's primary classification?
Psychologist is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Raytown, Missouri may find Unknown Individual in results; validate coverage separately.
How many locations tie to this NPI?
2 practice locations appear in the available data.