Unknown Individual – Clinical Psychologist, NPI 1023123759

Unknown Individual is a healthcare provider. based in Shelton, Washington. specializing in Clinical Psychologist. They hold a License No. 00003899 (WA). The NPI Number for Unknown Individual is 1023123759

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1023123759
Phone
(360) 426-2500
Address
237 PROFESSIONAL WAY
Deactivation Date
3 January 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

  • 237, Professional Way, Shelton, Mason County, Washington, 98584, United States

    SHELTON, WA 985844404

    Phone: (360) 426-2500

    Fax: (360) 426-2787

    Type: Location

  • 231, East Main Street, El Dorado, Union County, Arkansas, 71730, United States

    UNION, WA 985929630

    Phone: (360) 918-2955

    Fax: (360) 245-1000

    Type: Mailing

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 98584)

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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 1023123759.
Why is Unknown Individual marked inactive in the NPI directory?
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.
Where should I expect Unknown Individual on a map?
Expect Shelton, Washington as a primary anchor for Unknown Individual unless the record lists multiple sites.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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