Unknown Individual – Clinical Social Worker, NPI 1770619769

Unknown Individual is a healthcare provider. based in Presque isle, Michigan. specializing in Clinical Social Worker. They hold a License No. 6801087698 (MI). The NPI Number for Unknown Individual is 1770619769

Main info

Organization
Inactive
24 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1770619769
Phone
(989) 356-2161
Address
9697 BLUE HORIZON RD
Deactivation Date
14 July 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9893562161
Graduation Year
2002 (24 years ago)
PAC ID
2769528488
Group Practice PAC ID
2264498005
Professional Enrollment ID
I20091012000196
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

Provider Addresses for Unknown Individual

  • 9697 BLUE HORIZON RD

    PRESQUE ISLE, MI 497779087

    Phone: (989) 356-2161

    Type: Mailing

  • 400 JOHNSON ST

    ALPENA, MI 497071434

    Phone: (989) 356-2161

    Fax: (989) 354-5898

    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 49777)

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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: 2264498005View full group profile
NameSpecialtyState
Physician AssistantMI
P S Y C H I A T R YMI
Clinical Social WorkerMI
Occupational Therapist In Private PracticeMI
Clinical Social WorkerMI
Clinical Social WorkerMI
Clinical Social WorkerMI
P S Y C H I A T R YMI
Mental Health CounselorMI
Nurse PractitionerMI

Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1770619769 on file in the registry.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Presque Isle, Michigan as the reference point for Unknown Individual, then confirm.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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