Unknown Individual – Clinical Social Worker, NPI 1013963578

Unknown Individual is a healthcare provider. based in West bloomfield, Michigan. specializing in Clinical Social Worker. They hold a License No. 019451 (MI). The NPI Number for Unknown Individual is 1013963578

Main info

Organization
Inactive
43 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1013963578
Phone
(248) 626-1500
Address
6960 ORCHARD LAKE RD
Deactivation Date
30 September 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2486261500
Graduation Year
1983 (43 years ago)
PAC ID
3678561040
Group Practice PAC ID
0648225664
Professional Enrollment ID
I20060607000032
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Orchard Lake Road, West Bloomfield Township, Oakland County, Michigan, 48334, United States

    100

    WEST BLOOMFIELD, MI 483224515

    Phone: (248) 626-1500

    Fax: (248) 626-1551

    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 48322)

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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: 0648225664View full group profile
NameSpecialtyState
Clinical Social WorkerMI
Clinical Social WorkerMI
-MI
Clinical Social WorkerMI
-MI
Clinical PsychologistMI
Clinical Social WorkerMI
Clinical Social WorkerMI
Clinical Social WorkerMI
Clinical PsychologistMI

Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1013963578.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
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.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with West Bloomfield, Michigan in the same public data insurers reference.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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