Unknown Individual – Clinical Social Worker, NPI 1578879631

Unknown Individual is a healthcare provider. based in Ketchikan, Alaska. specializing in Clinical Social Worker. They hold a License No. 907 (AK). The NPI Number for Unknown Individual is 1578879631

Main info

Organization
Inactive
21 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1578879631
Phone
(907) 225-2230
Address
PO BOX 8121
Deactivation Date
9 October 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9078864741
Graduation Year
2005 (21 years ago)
PAC ID
7618134958
Group Practice PAC ID
5890691315
Professional Enrollment ID
I20120130000242
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • PO BOX 8121

    KETCHIKAN, AK 99901

    Phone: (907) 225-2230

    Fax: (907) 225-2230

    Type: Mailing

  • 320 BAWDEN ST. #318

    KETCHIKAN, AK 99901

    Phone: (907) 225-2230

    Fax: (907) 225-2230

    Type: Location

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.

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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: 5890691315View full group profile
NameSpecialtyState
Nurse PractitionerTX
Physician AssistantDC
Family PracticeID
Registered Dietitian Or Nutrition ProfessionalAK
Family PracticeAK
Emergency MedicinePA
Physical Therapist In Private PracticeAK
P S Y C H I A T R YLA
Physical Therapist In Private PracticeAK
Clinical Social WorkerNC

Reviews

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Frequently asked questions

What is the standard ID for Unknown Individual in the U.S.?
In the U.S., Unknown Individual is identified by NPI 1578879631.
What does inactive NPI status mean for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Ketchikan, Alaska?
If you are local to Ketchikan, Alaska, Unknown Individual may be relevant to your search.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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