Unknown Individual – Clinical Social Worker, NPI 1194960377

Unknown Individual is a healthcare provider. based in Joplin, Missouri. specializing in Clinical Social Worker. They hold a License No. 2008033146 (MO). The NPI Number for Unknown Individual is 1194960377

Main info

Organization
Inactive
18 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1194960377
Phone
(417) 782-1910
Address
2702 CUNNINGHAM AVE
Deactivation Date
24 March 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4177821910
Graduation Year
2008 (18 years ago)
PAC ID
7113162462
Group Practice PAC ID
4688610603
Professional Enrollment ID
I20130314000467
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

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Provider Addresses for Unknown Individual

  • 2702, South Cunningham Avenue, Joplin, Jasper County, Missouri, 64804, United States

    STE A

    JOPLIN, MO 648041570

    Phone: (417) 782-1910

    Fax: (417) 782-1844

    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 64804)

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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: 4688610603View full group profile

Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1194960377; it appears in the national provider directory.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Missouri?
You will see Joplin, Missouri on file for Unknown Individual alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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