Unknown Individual – Clinical Psychologist, NPI 1790830719

Unknown Individual is a healthcare provider. based in Gloucester, Virginia. specializing in Clinical Psychologist. They hold a License No. 0810002924 (VA). The NPI Number for Unknown Individual is 1790830719

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1790830719
Phone
(804) 693-9933
Address
PO BOX 629
Deactivation Date
13 November 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

Loading map...

Provider Addresses for Unknown Individual

  • PO BOX 629

    6512 MAIN STREET

    GLOUCESTER, VA 23061

    Phone: (804) 693-9933

    Fax: (804) 693-4545

    Type: Mailing

  • 6512, Main Street, Edgehill, Gloucester, Gloucester County, Virginia, 23061, United States

    GLOUCESTER, VA 23061

    Phone: (804) 693-9933

    Fax: (804) 693-4545

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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 23061)

Loading plans...

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1790830719; it appears in the national provider directory.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
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.
What location metadata exists for Unknown Individual?
The page summarizes Gloucester, Virginia for Unknown Individual; expand the address list for detail.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1790830719. Always confirm identity and privileges with the practice and licensing boards.