Unknown Individual – Clinical Social Worker, NPI 1467488189

Clinical Social Worker

Unknown Individual is a healthcare provider. based in Kingsford, Michigan. specializing in Clinical Social Worker. They hold a License No. 6801085809 (MI). The NPI Number for Unknown Individual is 1467488189

Main info

Organization

Inactive

22 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1467488189

Phone

(906) 774-0522

Address

715 PYLE DR

Deactivation Date

16 December 2022

Doctor Profile

Medical School Name

OTHER

Secondary Phone

9068637841

Graduation Year

2004 (22 years ago)

PAC ID

2567463961

Group Practice PAC ID

4981652401

Professional Enrollment ID

I20070129000170

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience23

Completeness75

Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

715, Pyle Drive, Kingsford, Dickinson County, Michigan, 49802, United States
KINGSFORD, MI 498024456
Phone: (906) 774-0522
Fax: (906) 774-1570
Type: Mailing
Northpointe Behavioral Health, 401, 10th Avenue, Menominee, Menominee County, Michigan, 49858, United States
MENOMINEE, MI 498583009
Phone: (906) 863-7841
Fax: (906) 863-2833
Type: Location
OSCAR G. JOHNSON, VAMC
325 EAST H STREET
IRON MOUNTAIN, MI 49801
Phone: (906) 774-3300
Fax: (906) 779-3127
Type: Mailing

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 49802)

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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: 4981652401View full group profile

Name	Specialty	State
DIANE E ROELL (CFNP)	-	MI
ELISABETH VAUGHN ALQUIST (LMSW)	Clinical Social Worker	MI
JANET WHEDON (LMSW)	-	MI
MICHELLE HUNTER (LMSW)	-	MI
PATRICK WILLIAM SMITH (LLMSW)	Clinical Social Worker	MI
KRISTIN MARIE OLSEN (LMSW-C)	Clinical Social Worker	MI
DIEDRA HINDS-SPRINGSTROH	Nurse Practitioner	MI
ANGELA KAY BJORNE (LMSW)	-	MI
MRS. FRANCESCA ECONOMY	-	MI
MARIA NERAT	Clinical Social Worker	MI