Unknown Individual – Clinical Social Worker, NPI 1184752750

Clinical Social Worker

Unknown Individual is a healthcare provider. based in Mount dora, Florida. specializing in Clinical Social Worker. They hold a License No. SW6633 (FL). The NPI Number for Unknown Individual is 1184752750

Main info

Organization

Inactive

29 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1184752750

Phone

(352) 385-4771

Address

PO BOX 701

Deactivation Date

7 July 2022

Doctor Profile

Medical School Name

OTHER

Secondary Phone

3523656506

Graduation Year

1997 (29 years ago)

PAC ID

8527183722

Group Practice PAC ID

6608877659

Professional Enrollment ID

I20100910001014

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

Provider Addresses for Unknown Individual

PO BOX 701
MOUNT DORA, FL 327560701
Phone: (352) 385-4771
Type: Mailing
33057 PROFESSIONAL DRIVE
LAKE CENTER OF HOPE
LEESBURG, FL 34788
Phone: (352) 787-0081
Fax: (352) 314-9444
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.

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 32756)

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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: 6608877659View full group profile