Unknown Individual – Clinical Social Worker, NPI 1083821177

Clinical Social Worker

Unknown Individual is a healthcare provider. based in Egg harbor township, New Jersey. specializing in Clinical Social Worker. They hold a License No. 44SC04711700 (NJ). The NPI Number for Unknown Individual is 1083821177

Main info

Organization

Inactive

46 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1083821177

Phone

(609) 645-3435

Address

5043 ENGLISH CREEK AVE

Deactivation Date

20 September 2021

Doctor Profile

Medical School Name

OTHER

Secondary Phone

6096453435

Graduation Year

1980 (46 years ago)

PAC ID

2769437789

Professional Enrollment ID

I20050314000093

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

5043, English Creek Avenue, Anthony Canale Training Centre, Egg Harbor Township, Atlantic County, New Jersey, 08234, United States
45C
EGG HARBOR TOWNSHIP, NJ 082349612
Phone: (609) 645-3435
Fax: (609) 646-3698
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.

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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 08234)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?

Unknown Individual — NPI 1083821177 — is the standard way to identify this listing.

Is Unknown Individual's NPI deactivated?

The extract indicates Unknown Individual is not in an active NPI state.

What taxonomy line describes Unknown Individual?

For research purposes, treat Unknown Individual as Clinical Social Worker in this dataset. Clinical services aligned with this taxonomy classification.

Where should I expect Unknown Individual on a map?

Expect Egg Harbor Township, New Jersey as a primary anchor for Unknown Individual unless the record lists multiple sites.

Why does Unknown Individual have multiple addresses?

2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.