Unknown Individual – Clinical Social Worker, NPI 1679543763

Unknown Individual is a healthcare provider. based in Newton, Massachusetts. specializing in Clinical Social Worker. They hold a License No. 102663 (MA). The NPI Number for Unknown Individual is 1679543763

Main info

Organization
Inactive
60 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1679543763
Phone
(617) 332-2047
Address
2364 WASHINGTON ST
Deactivation Date
20 February 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6173322047
Graduation Year
1966 (60 years ago)
PAC ID
3577598515
Group Practice PAC ID
1759282304
Professional Enrollment ID
I20050928001296
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

  • 2362;2364;2366;2370, Washington Street, Newton Lower Falls, Newton, Middlesex County, Massachusetts, 02462, United States

    NEWTON, MA 024621440

    Phone: (617) 332-2047

    Fax: (617) 332-7341

    Mailing address matches the actual address.

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 02462)

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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: 1759282304View full group profile
NameSpecialtyState
P S Y C H I A T R YMA
P S Y C H I A T R YCA
P S Y C H I A T R YMA
Clinical PsychologistMA
P S Y C H I A T R YMA
-MA
-MA
Clinical Social WorkerMA
Clinical Social WorkerMA
Mental Health CounselorMA

Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1679543763.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
What does the directory say Unknown Individual does?
Insurance directories may phrase it differently, but here Unknown Individual maps to Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Newton, Massachusetts?
If you are local to Newton, Massachusetts, Unknown Individual may be relevant to your search.
Why is information missing for Unknown Individual?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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