Unknown Individual – Clinical Social Worker, NPI 1013996826

Clinical Social Worker

Unknown Individual is a healthcare provider. based in West frankfort, Illinois. specializing in Clinical Social Worker. They hold a License No. 149-010561 (IL). The NPI Number for Unknown Individual is 1013996826

Main info

Organization

Inactive

30 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1013996826

Phone

(618) 937-6483

Address

902 W MAIN ST

Deactivation Date

2 January 2025

Doctor Profile

Medical School Name

OTHER

Secondary Phone

6189376483

Graduation Year

1996 (30 years ago)

PAC ID

1456314707

Group Practice PAC ID

2961545173

Professional Enrollment ID

I20041108000559

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

902 W MAIN ST
WEST FRANKFORT, IL 628962210
Phone: (618) 937-6483
Fax: (618) 937-1440
Type: Mailing
2311 S ILLINOIS AVE
CARBONDALE, IL 629035912
Phone: (618) 457-6703
Fax: (618) 549-3734
Type: Location
1110, North Cedar Court, Carbondale, Jackson County, Illinois, 62901, United States
CARBONDALE, IL 629015300
Phone: (618) 457-4144
Fax: (618) 457-6091
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

HCPCS	Description	Services	Beneficiaries	Medicare allowed
90837	Psychotherapy, 1 hour	202	13	$0
90834	Psychotherapy, 45 minutes	36	13	$0
90791	Psychiatric diagnostic evaluation	18	15	$0

View full utilization report →

Insurance plans in this area (ZIP 62896)

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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: 2961545173View full group profile

Name	Specialty	State
ERIN LOEBNER (MSED, LCPC)	Mental Health Counselor	IL
MIRZA S A BAIG	Geriatric Psychiatry, Psychiatry	IL
ELAINA WARD	-	IL
JUSTIN LEIGH MCKEVITT (MSW,LCSW)	Clinical Social Worker	IL
TERESA ANNETTE EBLIN (LSW)	Clinical Social Worker	IL
MR. PETER N. HALLER (MS, LCPC)	Mental Health Counselor	IL
MRS. CARRIE ANN SEEHAUSEN (MA, LCPC)	Mental Health Counselor	IL
ELLYN E LOWRY (MS, LCPC)	Mental Health Counselor	IL
MRS. CAROL ANN WORTHINGTON (LCSW)	-	IL
FRANK MATLOCK (LCSW)	Clinical Social Worker	IL

Reviews

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Frequently asked questions

What is Unknown Individual's NPI number?

Unknown Individual's NPI is 1013996826 — the number used across U.S. healthcare to identify this provider.

Is Unknown Individual still active if the NPI shows inactive?

NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.

What area of care is associated with Unknown Individual?

Unknown Individual's record emphasizes Clinical Social Worker. Clinical services aligned with this taxonomy classification.

Where in Illinois is Unknown Individual registered?

Use West Frankfort, Illinois as the headline location for Unknown Individual here.

Can I trust this NPI listing for Unknown Individual?

The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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