Unknown Individual – Clinical Social Worker, NPI 1649474156

Unknown Individual is a healthcare provider. based in Millinocket, Maine. specializing in Clinical Social Worker. They hold a License No. CAC4201 (ME). The NPI Number for Unknown Individual is 1649474156

Main info

Organization
Inactive
19 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1649474156
Phone
(207) 949-3270
Address
57 Penobscot Ave
Deactivation Date
22 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2079730505
Graduation Year
2007 (19 years ago)
PAC ID
6800151622
Group Practice PAC ID
3375767023
Professional Enrollment ID
I20180529001841
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience27
Completeness75
Years active:0State licenses:3Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 57 Penobscot Ave

    Millinocket, ME 044621320

    Phone: (207) 949-3270

    Type: Location

  • 157 Park St Ste 34

    Bangor, ME 044015063

    Phone: (207) 949-3270

    Type: Location

  • 156 Oak St

    Old Town, ME 044681681

    Phone: (207) 217-1061

    Type: Location

  • 21 Main St Ste 301

    Bangor, ME 044016359

    Phone: (207) 217-1061

    Type: Location

  • 557 Hammond St

    Bangor, ME 04401

    Phone: (207) 973-0505

    Type: Location

  • 557, Hammond Street, Bangor, Penobscot County, Maine, 04401, United States

    BANGOR, ME 04401

    Phone: (207) 973-0505

    Type: Location

  • 57 PENOBSCOT AVE

    MILLINOCKET, ME 044621320

    Phone: (207) 949-3270

    Type: Mailing

  • 68 MOUNT HOPE AVE

    BANGOR, ME 044014096

    Phone: (207) 949-3270

    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 04462)

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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: 3375767023View full group profile
NameSpecialtyState
Mental Health CounselorME
Mental Health CounselorME
Mental Health CounselorME
Clinical Social WorkerME
-ME

Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1649474156.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Millinocket, Maine in our summary view.
How many locations tie to this NPI?
9 practice locations appear in the available data.

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