Unknown Individual – Clinical Social Worker, NPI 1124190715

Unknown Individual is a healthcare provider. based in Ossining, New York. specializing in Clinical Social Worker. They hold a License No. PR104874-1 (NY). The NPI Number for Unknown Individual is 1124190715

Main info

Organization
Inactive
35 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1124190715
Phone
(914) 271-2386
Address
100 EXECUTIVE BLVD
Deactivation Date
14 December 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9142712386
Graduation Year
1991 (35 years ago)
PAC ID
6406028570
Professional Enrollment ID
I20111014000009
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

  • 100, Executive Boulevard, Ossining, Town of Ossining, Westchester, New York, 10562, United States

    SUITE 104

    OSSINING, NY 105622557

    Phone: (914) 271-2386

    Fax: (914) 271-2386

    Type: Location

  • 87, Morningside Drive, Harmon, Village of Croton-on-Hudson, Town of Cortlandt, Westchester County, New York, 10520, United States

    CROTON ON HUDSON, NY 105202824

    Phone: (914) 271-2386

    Fax: (914) 271-2386

    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.

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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 10562)

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Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1124190715 as the unique 10-digit identifier.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Clinical Social Worker in the directory — Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Ossining, New York as the reference point for Unknown Individual, then confirm.
Can I trust this NPI listing for Unknown Individual?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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