Unknown Individual – Clinical Social Worker, NPI 1265647325

Unknown Individual is a healthcare provider. based in Middletown, Connecticut. specializing in Clinical Social Worker. They hold a License No. 002080 (CT). The NPI Number for Unknown Individual is 1265647325

Main info

Organization
Inactive
40 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1265647325
Phone
(860) 524-6567
Address
99 SMITH ST
Deactivation Date
8 May 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8606463888
Graduation Year
1986 (40 years ago)
PAC ID
7214087147
Group Practice PAC ID
5597652149
Professional Enrollment ID
I20090615000307
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

  • 99, Smith Street, Achenbach, Westfield, Middletown, Lower Connecticut River Valley Planning Region, Connecticut, 06457, United States

    MIDDLETOWN, CT 064571740

    Phone: (860) 524-6567

    Fax: (860) 632-0286

    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 06457)

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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: 5597652149View full group profile
NameSpecialtyState
Clinical Social WorkerCT
Mental Health CounselorCT
Clinical Social WorkerCT
Nurse PractitionerCT
Mental Health CounselorCT
Mental Health CounselorCT
-CT
-CT
Clinical Social WorkerCT
Nurse PractitionerCT

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 1265647325.
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 Middletown, Connecticut?
If you are local to Middletown, Connecticut, Unknown Individual may be relevant to your search.
Why is information missing for Unknown Individual?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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