Unknown Individual – Social Worker, NPI 1962523779

Unknown Individual is a healthcare provider. based in Fenton, Missouri. specializing in Social Worker. They hold a License No. SW002493 (MO). The NPI Number for Unknown Individual is 1962523779

Main info

Organization
Inactive
38 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1962523779
Phone
(636) 343-4083
Address
499 BOWLES AVENUE
Deactivation Date
12 October 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3146312003
Graduation Year
1988 (38 years ago)
PAC ID
7719936269
Professional Enrollment ID
I20050121000571
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

Provider Addresses for Unknown Individual

  • 499 BOWLES AVENUE

    FENTON, MO 63026

    Phone: (636) 343-4083

    Fax: (636) 343-4083

    Type: Mailing

  • STUBBLEFIELD CARE CTR

    5349 HWY P

    CUBA, MO 65453

    Phone: (573) 885-3661

    Fax: (573) 885-6454

    Type: Location

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.

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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.

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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 63026)

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Reviews

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Frequently asked questions

What identifier follows Unknown Individual across health systems?
The NPI 1962523779 uniquely identifies Unknown Individual in U.S. healthcare data.
Does inactive mean outdated data for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
What does the directory say Unknown Individual does?
Insurance directories may phrase it differently, but here Unknown Individual maps to Social Worker. Clinical services aligned with this taxonomy classification.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Fenton, Missouri in registry-derived data.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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