Unknown Individual – Social Worker, NPI 1124541552

Social Worker

Unknown Individual is a healthcare provider. based in Kansas city, Missouri. specializing in Social Worker. They hold a License No. 2016007617 (MO). The NPI Number for Unknown Individual is 1124541552

Main info

Organization

Inactive

25 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1124541552

Phone

(816) 508-3569

Address

300 E 36TH ST

Deactivation Date

8 May 2024

Doctor Profile

Medical School Name

OTHER

Secondary Phone

6183171537

Graduation Year

2001 (25 years ago)

PAC ID

2769744549

Group Practice PAC ID

5991002420

Professional Enrollment ID

I20180314000591

Data current as of

20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience28

Completeness75

Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

300, East 36th Street, Central Hyde Park, Westport, Kansas City, Jackson County, Missouri, 64111, United States
KANSAS CITY, MO 641111410
Phone: (816) 508-3569
Fax: (816) 508-1757
Type: Mailing
1750, South Brentwood Boulevard, Brentwood, Saint Louis County, Missouri, 63144, United States
SAINT LOUIS, MO 631441315
Phone: (816) 508-3569
Fax: (816) 508-1757
Type: Location
4601 STATE ST STE 220
EAST SAINT LOUIS, IL 622051359
Phone: (618) 741-9635
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 64111)

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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: 5991002420View full group profile

Name	Specialty	State
RENAE M BELT (LMSW)	Clinical Social Worker	MO
CAROLYN SUE ENDICOTT (MSW, LCSW)	Clinical Social Worker	IL
MORGAN ALYSSE WILSON	Clinical Social Worker	OH
DONNA M TEBBE (LCSW)	-	IL
PATRICIA STRADER (LCSW)	-	IL
LINDA A SCHUH (LCSW)	-	IL
JESSICA BEASLEY GUNTHER	Clinical Social Worker	IL
CYNTHIA LOUISE KIEFFER	-	IL
VALERIE DUFF (LCSW)	Clinical Social Worker	IL
PAMELA SUE JACKSON (LCSW)	-	IL

Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?

You can confirm Unknown Individual with NPI 1124541552; it appears in the national provider directory.

Should I trust care from Unknown Individual if status is inactive?

An inactive NPI does not by itself prove someone stopped practicing — check other sources.

What does Unknown Individual treat or focus on?

Patients typically see Unknown Individual under the specialty Social Worker. Clinical services aligned with this taxonomy classification.

Where is Unknown Individual's primary listing?

We display Kansas City, Missouri because that is what the record indicates for Unknown Individual.

Does Medicare enrollment show here?

Medicare enrollment screens are separate from the basic NPI extract shown here.

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