Unknown Individual – Clinical Psychologist, NPI 1063565430

Unknown Individual is a healthcare provider. based in Woodbridge, Virginia. specializing in Clinical Psychologist. They hold a License No. 0810001760 (VA). The NPI Number for Unknown Individual is 1063565430

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1063565430
Phone
(703) 497-0282
Address
12866 HARBOR DR
Deactivation Date
26 February 2026
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

  • Prince William County Juvenile Court Service Unit - Woodbridge Office, Donald Curtis Drive, Garfield Estates, Leesylvania, Prince William County, Virginia, 22191, United States

    WOODBRIDGE, VA 221922921

    Phone: (703) 497-0282

    Fax: (703) 490-4906

    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 22192)

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Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1063565430.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What does the directory say Unknown Individual does?
Insurance directories may phrase it differently, but here Unknown Individual maps to Clinical Psychologist. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Woodbridge, Virginia. Check all listed addresses for suites or satellite offices.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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