Unknown Individual – Clinical Social Worker, NPI 1174740104

Unknown Individual is a healthcare provider. based in Corbin, Kentucky. specializing in Clinical Social Worker. They hold a License No. 3085 (KY). The NPI Number for Unknown Individual is 1174740104

Main info

Organization
Inactive
22 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1174740104
Phone
Not provided
Address
PO BOX 568
Deactivation Date
16 April 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6065731624
Graduation Year
2004 (22 years ago)
PAC ID
3072604420
Group Practice PAC ID
4587561790
Professional Enrollment ID
I20070814000537
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 568

    CORBIN, KY 407020568

    Phone:

    Type: Mailing

  • 1203 AMERICAN GREETING RD

    CORBIN, KY 407014811

    Phone: (606) 528-7010

    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
90837Psychotherapy, 1 hour4713$0
90834Psychotherapy, 45 minutes2312$0
View full utilization report →

Insurance plans in this area (ZIP 40702)

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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: 4587561790View full group profile
NameSpecialtyState
Mental Health CounselorKY
Mental Health CounselorKY
Clinical PsychologistKY
Marriage And Family TherapistKY
Physician AssistantKY
-KY
Physician AssistantKY
Mental Health CounselorKY
Nurse PractitionerKY
Nurse PractitionerKY

Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1174740104 is assigned to Unknown Individual under the national enumeration system.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface Corbin, Kentucky for Unknown Individual based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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