Unknown Individual – Clinical Psychologist, NPI 1205896586

Unknown Individual is a healthcare provider. based in Beavercreek, Ohio. specializing in Clinical Psychologist. They hold a License No. 2290 (OH). The NPI Number for Unknown Individual is 1205896586

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1205896586
Phone
(937) 429-1441
Address
3333C DAYTON XENIA ROAD
Deactivation Date
10 July 2024
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

  • Dayton-Xenia Road, Zimmerman, Beavercreek, Greene County, Ohio, 45432, United States

    BEAVERCREEK, OH 454322764

    Phone: (937) 429-1441

    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.

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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 45432)

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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 1205896586.
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 healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Clinical Psychologist. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Beavercreek, Ohio in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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