Unknown Individual – Clinical Social Worker, NPI 1154433159

Unknown Individual is a healthcare provider. based in Dubre, Kentucky. specializing in Clinical Social Worker. They hold a License No. 1607 (KY). The NPI Number for Unknown Individual is 1154433159

Main info

Organization
Inactive
54 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1154433159
Phone
(270) 901-5000
Address
600 FERRIS CREEK RD
Deactivation Date
13 December 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2709015000
Graduation Year
1972 (54 years ago)
PAC ID
1557425329
Group Practice PAC ID
8820902638
Professional Enrollment ID
I20090123000323
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

  • 600 FERRIS CREEK RD

    DUBRE, KY 427318551

    Phone: (270) 901-5000

    Fax: (270) 842-5268

    Type: Mailing

  • Sartin Drive, Edmonton, Metcalfe County, Kentucky, 42129, United States

    EDMONTON, KY 42129

    Phone: (270) 432-2266

    Fax: (270) 432-5054

    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.

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90834Psychotherapy, 45 minutes3916$0
90832Psychotherapy, 30 minutes2919$0
View full utilization report →

Insurance plans in this area (ZIP 42731)

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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: 8820902638View full group profile
NameSpecialtyState
Clinical Social WorkerKY
Clinical Social WorkerKY
P S Y C H I A T R YKY
Mental Health CounselorKY
-KY
Clinical PsychologistKY
Nurse PractitionerKY
-KY
Clinical Social WorkerKY
Nurse PractitionerKY

Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1154433159 for Unknown Individual, then check state licensing separately.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Dubre, Kentucky in the data we show; additional addresses may exist on the full record.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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