Unknown Individual – Social Worker, NPI 1669717617

Unknown Individual is a healthcare provider. based in Eden prairie, Minnesota. specializing in Social Worker. They hold a License No. 20687 (MN). The NPI Number for Unknown Individual is 1669717617

Main info

Organization
Inactive
24 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1669717617
Phone
(952) 224-2282
Address
7525 MITCHELL RD STE 100
Deactivation Date
16 November 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6514540114
Graduation Year
2002 (24 years ago)
PAC ID
8729316823
Group Practice PAC ID
2860304045
Professional Enrollment ID
I20190828001004
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

  • 7525 MITCHELL RD STE 100

    EDEN PRAIRIE, MN 553441900

    Phone: (952) 224-2282

    Fax: (952) 224-2284

    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 55344)

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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: 2860304045View full group profile
NameSpecialtyState
Mental Health CounselorMN
Clinical Social WorkerMN
Clinical PsychologistMN
Clinical Social WorkerMN
Mental Health CounselorMN
Marriage And Family TherapistMN
-NJ
Mental Health CounselorVA
-MN
Nurse PractitionerMN

Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1669717617?
NPI 1669717617 belongs to Unknown Individual; compare other details if you need extra assurance.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Social Worker. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Eden Prairie, Minnesota.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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