Unknown Individual – Clinical Social Worker, NPI 1356434542

Unknown Individual is a healthcare provider. based in Ketchikan, Alaska. specializing in Clinical Social Worker. They hold a License No. 1940 (KS). The NPI Number for Unknown Individual is 1356434542

Main info

Organization
Inactive
33 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1356434542
Phone
(907) 225-7825
Address
721 STEDMAN ST
Deactivation Date
10 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3606835900
Graduation Year
1993 (33 years ago)
PAC ID
5092724401
Group Practice PAC ID
2365349495
Professional Enrollment ID
I20180719001997
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 721, Stedman Street, Ketchikan, Ketchikan Gateway, Alaska, 99901, United States

    KETCHIKAN, AK 999016632

    Phone: (907) 225-7825

    Fax: (907) 225-1541

    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 99901)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2365349495View full group profile
NameSpecialtyState
Physician AssistantWA
-WA
Physician AssistantWA
Nurse PractitionerWA
Family PracticeWA
Family PracticeWA
-WA
Nurse PractitionerWA
Family PracticeID
Family PracticeWA

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1356434542; 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.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Ketchikan, Alaska for Unknown Individual; download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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