Unknown Individual – Clinical Social Worker, NPI 1366521148

Unknown Individual is a healthcare provider. based in New baltimore, Michigan. specializing in Clinical Social Worker. They hold a License No. 6801003869 (MI). The NPI Number for Unknown Individual is 1366521148

Main info

Organization
Inactive
37 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1366521148
Phone
(586) 263-2760
Address
50486 JEFFERSON AVE
Deactivation Date
22 February 2022

Doctor Profile

Medical School Name
WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
3139162600
Graduation Year
1989 (37 years ago)
PAC ID
0648557967
Group Practice PAC ID
0547178311
Professional Enrollment ID
I20170515000565
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

Provider Addresses for Unknown Individual

  • 50486, Jefferson Avenue, Chesterfield Shores, New Baltimore, Macomb County, Michigan, 48047, United States

    NEW BALTIMORE, MI 480472327

    Phone: (586) 263-2760

    Fax: (586) 263-2762

    Type: Mailing

  • 43411 Garfield Rd Ste A

    Clinton Township, MI 480381152

    Phone: (586) 263-2760

    Fax: (586) 263-2762

    Type: Location

  • 19 Mile Road, Clinton Township, Macomb County, Michigan, 48038, United States

    CLINTON TWP, MI 480386338

    Phone: (800) 653-6568

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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 48047)

Loading plans...

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: 0547178311View full group profile
NameSpecialtyState
-MI
Gastroenterology, Internal MedicinePA
Certified Registered Nurse Anesthetist (Crna)MI
Clinical Social WorkerMI
-MI
Physician AssistantMI
Qualified AudiologistMI
O P H T H A L M O L O G YMI
-MI
-MI

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1366521148 is assigned to Unknown Individual under the national enumeration system.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists New Baltimore, Michigan for Unknown Individual; download NPPES for the complete set.
How can I contact Unknown Individual?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

Similar Providers

29750 Harper Ave
NPI: 1679675201

Unknown Individual

Clinical Social Worker
51808 OXFORD CT
NPI: 1316074552
33694 BAYVIEW DR
NPI: 1396961405

MRS. REBECCA LYNN KONARZ (LMSW)

Clinical Social Worker
35587 Brooke Ct
NPI: 1609035245

MS. TERRI ELLEN DUGANNE (LMSW)

Clinical Social Worker
35031, 23 Mile Road, New Baltimore, Macomb County, Michigan, 48047, United States
NPI: 1790019404

P & C ADULT DAY CENTER LLC

Clinical Social Worker
51614 RIVARD RD
NPI: 1790098663

MR. GREGORY D SZOPO

Clinical Social Worker
54015 ATHERTON ST
NPI: 1588947949
35054 23 MILE RD
NPI: 1194137893