Unknown Individual – Clinical Social Worker, NPI 1285049791

Unknown Individual is a healthcare provider. based in Monticello, Arkansas. specializing in Clinical Social Worker. They hold a License No. 6940C (AR). The NPI Number for Unknown Individual is 1285049791

Main info

Organization
Inactive
13 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1285049791
Phone
(870) 367-2461
Address
790 ROBERTS DRIVE
Deactivation Date
7 February 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8703672461
Graduation Year
2013 (13 years ago)
PAC ID
4688984560
Group Practice PAC ID
1850377508
Professional Enrollment ID
I20151104002600
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

  • 790 ROBERTS DRIVE

    MONTICELLO, AR 71655

    Phone: (870) 367-2461

    Fax: (870) 460-6133

    Type: Mailing

  • 708 HIGHWAY 65 S

    DUMAS, AR 716393004

    Phone: (870) 382-4001

    Fax: (870) 382-6094

    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 71655)

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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: 1850377508View full group profile
NameSpecialtyState
Mental Health CounselorAR
Clinical Social WorkerAR
P S Y C H I A T R YAR
Mental Health CounselorAR
Mental Health CounselorAR
Clinical Social WorkerAR
P S Y C H I A T R YAR
Nurse PractitionerAR
Clinical Social WorkerAR
-AR

Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1285049791.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Monticello, Arkansas in the data we show; additional addresses may exist on the full record.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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