Unknown Individual – Clinical Social Worker, NPI 1073612966

Unknown Individual is a healthcare provider. based in Midland, Michigan. specializing in Clinical Social Worker. They hold a License No. 6801062021 (MI). The NPI Number for Unknown Individual is 1073612966

Main info

Organization
Inactive
36 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1073612966
Phone
(313) 318-3646
Address
218 PRINCETON CT
Deactivation Date
24 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9894269295
Graduation Year
1990 (36 years ago)
PAC ID
9436159316
Group Practice PAC ID
4688660533
Professional Enrollment ID
I20061226000165
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

  • 218, Princeton Court, Center City, Midland, Midland County, Michigan, 48640, United States

    MIDLAND, MI 486404546

    Phone: (313) 318-3646

    Type: Mailing

  • 2603, West Wackerly Street, Midland, Midland County, Michigan, 48640, United States

    MIDLAND, MI 486406903

    Phone: (989) 631-2320

    Fax: (989) 631-9903

    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 48640)

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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: 4688660533View full group profile
NameSpecialtyState
P S Y C H I A T R YFL
P S Y C H I A T R YOH
-MI
Clinical Social WorkerMI
-MI
-FL
P S Y C H I A T R YMI
-MI
Clinical Social WorkerMI
Clinical Social WorkerMI

Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1073612966.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What kind of provider is Unknown Individual?
The page reflects Clinical Social Worker for Unknown Individual. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Midland, Michigan for Unknown Individual; expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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