Unknown Individual – Mental Health Counselor, NPI 1629040779

Unknown Individual is a healthcare provider. based in Muncie, Indiana. specializing in Mental Health Counselor. The NPI Number for Unknown Individual is 1629040779

Main info

Organization
Inactive
24 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1629040779
Phone
(765) 602-3723
Address
7609 S SUN MOR DR
Deactivation Date
18 February 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3172537387
Graduation Year
2002 (24 years ago)
PAC ID
5799833653
Group Practice PAC ID
4688667488
Professional Enrollment ID
I20090501000468
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience5
Completeness75
Years active:0State licenses:0Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 7609 S SUN MOR DR

    MUNCIE, IN 473029433

    Phone: (765) 602-3723

    Fax: (888) 781-5085

    Type: Mailing

  • 17, South 20th Street, Shockoe Bottom, Richmond, Virginia, 23223, United States

    RICHMOND, IN 473745721

    Phone: (765) 602-3723

    Fax: (888) 781-5085

    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 47302)

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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: 4688667488View full group profile

Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1629040779 — is the standard way to identify this listing.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual's primary classification?
Mental Health Counselor is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Muncie, Indiana may find Unknown Individual in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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