Unknown Individual – Social Worker, NPI 1245247618

Unknown Individual is a healthcare provider. based in Champlin, Minnesota. specializing in Social Worker. They hold a License No. 2338 (MN). The NPI Number for Unknown Individual is 1245247618

Main info

Organization
Inactive
48 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1245247618
Phone
(763) 951-3091
Address
11141 ZEALAND AVE N
Deactivation Date
24 March 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7639513091
Graduation Year
1978 (48 years ago)
PAC ID
0042265951
Group Practice PAC ID
4284887472
Professional Enrollment ID
I20050314000795
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

  • 11141, Zealand Avenue North, Champlin, Hennepin County, Minnesota, 55316, United States

    CHAMPLIN, MN 553163595

    Phone: (763) 951-3091

    Fax: (763) 951-3097

    Mailing address matches the actual address.

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 55316)

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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: 4284887472View full group profile
NameSpecialtyState
Marriage And Family TherapistMN
Marriage And Family TherapistMN
-MN
Mental Health CounselorMN
Marriage And Family TherapistMN
Mental Health CounselorMN

Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1245247618 if you need a stable reference for Unknown Individual.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Social Worker. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Minnesota?
You will see Champlin, Minnesota on file for Unknown Individual alongside any extra practice locations.
What if Champlin, Minnesota seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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