Unknown Individual – Clinical Social Worker, NPI 1063870277

Unknown Individual is a healthcare provider. based in Cloquet, Minnesota. specializing in Clinical Social Worker. They hold a License No. 22142 (MN). The NPI Number for Unknown Individual is 1063870277

Main info

Organization
Inactive
14 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1063870277
Phone
(218) 879-4559
Address
40 11th St
Deactivation Date
7 June 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2188794559
Graduation Year
2012 (14 years ago)
PAC ID
7618255423
Group Practice PAC ID
2961485909
Professional Enrollment ID
I20161031000324
Data current as of
20 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

  • 40 11th St

    Cloquet, MN 557201817

    Phone: (218) 879-4559

    Fax: (218) 879-0282

    Type: Location

  • 1401, East 1st Street, Duluth, Saint Louis County, Minnesota, 55805, United States

    DULUTH, MN 558052407

    Phone: (218) 728-4491

    Fax: (218) 730-2367

    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 55720)

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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: 2961485909View full group profile
NameSpecialtyState
Mental Health CounselorWI
Clinical Social WorkerMN
Clinical Social WorkerMN
Clinical Social WorkerMN
Clinical Social WorkerMN
Mental Health CounselorMN
Mental Health CounselorMN
Mental Health CounselorMN
P S Y C H I A T R YMN
Clinical Social WorkerMN

Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1063870277 for Unknown Individual.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
How should patients interpret Unknown Individual's specialty?
The extract shows Clinical Social Worker for Unknown Individual. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Cloquet, Minnesota in the same public data insurers reference.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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