Unknown Individual – Clinical Social Worker, NPI 1972546869

Unknown Individual is a healthcare provider. based in Beachwood, Ohio. specializing in MENTAL HEALTH COUNSELOR. They hold a License No. E3967 (OH). The NPI Number for Unknown Individual is 1972546869

Main info

Organization
Inactive
37 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1972546869
Phone
(216) 831-6611
Address
24800 HIGHPOINT RD
Deactivation Date
16 April 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4403922222
Graduation Year
1989 (37 years ago)
PAC ID
8224572128
Group Practice PAC ID
9032337308
Professional Enrollment ID
I20240702004112
Address ID
OH440605743ME8224XAVEX306
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

2,538 MENTAL HEALTH COUNSELOR in OH

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Provider Addresses for Unknown Individual

  • 24800, Highpoint Road, Beachwood, Cuyahoga County, Ohio, 44122, United States

    BEACHWOOD, OH 441226041

    Phone: (216) 831-6611

    Fax: (216) 831-2726

    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.

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240702004112IMental Health CounselorOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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 44122)

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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: 9032337308View full group profile
NameSpecialtyState
P S Y C H I A T R YOH
Clinical PsychologistMI
Clinical PsychologistOH
Clinical Social WorkerOH
Clinical PsychologistOH
Mental Health CounselorOH
Clinical PsychologistOH
Mental Health CounselorOH
P S Y C H I A T R YOH

Reviews

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Frequently asked questions

What is Unknown Individual's NPI number?
Unknown Individual's NPI is 1972546869 — the number used across U.S. healthcare to identify this provider.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Beachwood, Ohio 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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