Unknown Individual – Clinical Social Worker, NPI 1003965666

Unknown Individual is a healthcare provider. based in Ashland, Kentucky. specializing in Clinical Social Worker. They hold a License No. 3028 (KY). The NPI Number for Unknown Individual is 1003965666

Main info

Organization
Inactive
26 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1003965666
Phone
(606) 329-8588
Address
PO BOX 790
Deactivation Date
19 January 2021

Doctor Profile

Medical School Name
UNIVERSITY OF KENTUCKY COLLEGE OF MEDICINE
Secondary Phone
6064745151
Graduation Year
2000 (26 years ago)
PAC ID
6800999152
Group Practice PAC ID
1254239171
Professional Enrollment ID
I20190130000659
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 790

    ASHLAND, KY 411050790

    Phone: (606) 329-8588

    Fax: (606) 329-8195

    Type: Mailing

  • 223 Carlton Davidson Ln

    Coal Grove, OH 456382924

    Phone: (740) 532-3048

    Fax: (740) 532-4859

    Type: Location

  • Interstate Drive, Grayson, Carter County, Kentucky, 41143, United States

    GRAYSON, KY 411431768

    Phone: (606) 474-5151

    Fax: (606) 475-3219

    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 41105)

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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: 1254239171View full group profile
NameSpecialtyState
Nurse PractitionerKY
Mental Health CounselorKY
Clinical Social WorkerKY
Mental Health CounselorKY
Pediatric Medicine, Family Practice, Addiction MedicineWV
Mental Health CounselorKY
Clinical Social WorkerKY
Mental Health CounselorKY
Mental Health CounselorKY
Mental Health CounselorKY

Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1003965666.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
Which specialty label fits Unknown Individual?
NPPES ties Unknown Individual to Clinical Social Worker in the taxonomy section. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Ashland, Kentucky. Check all listed addresses for suites or satellite offices.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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