Unknown Individual – Clinical Social Worker, NPI 1063444701

Unknown Individual is a healthcare provider. based in Ridgewood, New Jersey. specializing in Clinical Social Worker. They hold a License No. 44SC05212000 (NJ). The NPI Number for Unknown Individual is 1063444701

Main info

Organization
Inactive
28 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1063444701
Phone
(201) 390-1800
Address
111 E RIDGEWOOD AVE
Deactivation Date
15 May 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2013901800
Graduation Year
1998 (28 years ago)
PAC ID
7810933538
Professional Enrollment ID
I20050706000164
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

  • Hekemian Residential Community, 111, East Ridgewood Avenue, Downtown Ridgewood, Ridgewood, Bergen County, New Jersey, 07451, United States

    SUITE 2 B

    RIDGEWOOD, NJ 074503866

    Phone: (201) 390-1800

    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 07450)

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Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1063444701 on file in the registry.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Ridgewood, New Jersey as the reference point for Unknown Individual, then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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