Unknown Individual – Clinical Social Worker, NPI 1396904652

Unknown Individual is a healthcare provider. based in Wilmington, Delaware. specializing in Clinical Social Worker. They hold a License No. Q1-0000892 (DE). The NPI Number for Unknown Individual is 1396904652

Main info

Organization
Inactive
19 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1396904652
Phone
(302) 290-2774
Address
18C TROLLEY SQ
Deactivation Date
22 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3024789411
Graduation Year
2007 (19 years ago)
PAC ID
1759685233
Group Practice PAC ID
4082643739
Professional Enrollment ID
I20160203001049
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

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Provider Addresses for Unknown Individual

  • 18, Trolley Square, Wilmington, New Castle County, Delaware, 19806, United States

    WILMINGTON, DE 198063355

    Phone: (302) 290-2774

    Fax: (302) 994-4432

    Type: Location

  • 116 DAVID RD

    WILMINGTON, DE 198042665

    Phone: (302) 290-2774

    Fax: (302) 994-4432

    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 19806)

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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: 4082643739View full group profile
NameSpecialtyState
Clinical PsychologistDE
Internal Medicine, Geriatric MedicineDE
Clinical Social WorkerDE
Mental Health CounselorPA
Clinical Social WorkerDE
Mental Health CounselorDE
-DE
Clinical Social WorkerNY
Clinical Social WorkerDE
Clinical Social WorkerDE

Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1396904652 for Unknown Individual, then check state licensing separately.
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 best known for clinically?
Directory data describes Unknown Individual with Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Wilmington, Delaware as a primary anchor for Unknown Individual unless the record lists multiple sites.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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