Unknown Individual – Psychologist, NPI 1265496293

Unknown Individual is a healthcare provider. based in Media, Pennsylvania. specializing in Psychologist. They hold a License No. PS004964L (PA). The NPI Number for Unknown Individual is 1265496293

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1265496293
Phone
(610) 543-3418
Address
501 N PROVIDENCE RD
Deactivation Date
9 October 2025
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

  • 501, North Providence Road, Rose Tree, Media, Delaware County, Pennsylvania, 19063, United States

    #103

    MEDIA, PA 190632557

    Phone: (610) 543-3418

    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 19063)

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Reviews

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Frequently asked questions

What is Unknown Individual's NPI number?
Unknown Individual's NPI is 1265496293 — the number used across U.S. healthcare to identify this provider.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Psychologist. Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Media?
Unknown Individual currently maps to Media, Pennsylvania in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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