Unknown Individual – Clinical Social Worker, NPI 1184799652

Unknown Individual is a healthcare provider. based in Brunswick, Georgia. specializing in Clinical Social Worker. They hold a License No. 506 (GA). The NPI Number for Unknown Individual is 1184799652

Main info

Organization
Inactive
56 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1184799652
Phone
(912) 264-2369
Address
502 GLOUCESTER ST
Deactivation Date
6 February 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3185167218
Graduation Year
1970 (56 years ago)
PAC ID
2860654183
Professional Enrollment ID
I20120503000232
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

  • 502, Gloucester Street, Glynnvilla, Brunswick, Glynn County, Georgia, 31520, United States

    SUITE 8

    BRUNSWICK, GA 315207013

    Phone: (912) 264-2369

    Fax: (912) 264-2365

    Type: Location

  • Brunswick Post Office, Sydney Road, Brunswick, Melbourne, Victoria, 3056, Australia

    BRUNSWICK, GA 315211932

    Phone: (912) 264-2369

    Fax: (912) 264-2365

    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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90837Psychotherapy, 1 hour38432$0
90791Psychiatric diagnostic evaluation1717$0
View full utilization report →

Insurance plans in this area (ZIP 31520)

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Reviews

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1184799652.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Brunswick?
Public fields place Unknown Individual around Brunswick, Georgia. Always confirm the exact site before visiting.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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