Unknown Individual – Addiction (Substance Use Disorder) Counselor, NPI 1649208356

Unknown Individual is a healthcare provider. based in Columbus, Ohio. specializing in Addiction (Substance Use Disorder) Counselor. They hold a License No. 944095 (OH). The NPI Number for Unknown Individual is 1649208356

Main info

Organization
Inactive
46 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1649208356
Phone
(614) 227-6865
Address
40 SPRUCE ST
Deactivation Date
30 September 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6142996600
Graduation Year
1980 (46 years ago)
PAC ID
6406000348
Group Practice PAC ID
5193612539
Professional Enrollment ID
I20130131000283
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 40, Spruce Street, Park Street District, Columbus, Franklin, Ohio, 43215, United States

    COLUMBUS, OH 432152204

    Phone: (614) 227-6865

    Fax: (614) 227-6873

    Type: Location

  • 1429, Dickson Drive, Scioto Woods, Columbus, Franklin County, Ohio, 43228, United States

    COLUMBUS, OH 432287039

    Phone: (614) 274-6970

    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.

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 43215)

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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: 5193612539View full group profile
NameSpecialtyState
-OH
-OH
Nurse PractitionerOH
-OH
Clinical Social WorkerOH
Nurse PractitionerOH
Nurse PractitionerOH
P S Y C H I A T R YOH
Addiction Medicine, Pain ManagementOH
Clinical Social WorkerOH

Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1649208356?
NPI 1649208356 belongs to Unknown Individual; compare other details if you need extra assurance.
Is Unknown Individual still active if the NPI shows inactive?
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 Addiction (Substance Use Disorder) Counselor in the directory — Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Columbus?
Unknown Individual currently maps to Columbus, Ohio in this extract.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.