Unknown Individual – Clinical Psychologist, NPI 1013969682

Unknown Individual is a healthcare provider. based in Wynnewood, Pennsylvania. specializing in Clinical Psychologist. They hold a License No. PS002674L (PA). The NPI Number for Unknown Individual is 1013969682

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1013969682
Phone
(610) 642-2353
Address
308 E LANCASTER AVE
Deactivation Date
29 July 2022
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

  • 308, East Lancaster Avenue, Wynnebrook Manor, Wynnewood, Ardmore, Lower Merion Township, Montgomery County, Pennsylvania, 19096, United States

    SUITE 200

    WYNNEWOOD, PA 190962145

    Phone: (610) 642-2353

    Fax: (610) 642-3278

    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 19096)

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Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1013969682 is assigned to Unknown Individual under the national enumeration system.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
Does Unknown Individual list a primary specialty?
If you are matching referrals, note Clinical Psychologist for Unknown Individual. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Wynnewood, Pennsylvania for Unknown Individual; download NPPES for the complete set.
How can I contact Unknown Individual?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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