Unknown Individual – Psychiatric/Mental Health Clinical Nurse Specialist, NPI 1215994306

Unknown Individual is a healthcare provider. based in Woonsocket, Rhode Island. specializing in Psychiatric/Mental Health Clinical Nurse Specialist. They hold a License No. PPNS00027 (RI). The NPI Number for Unknown Individual is 1215994306

Main info

Organization
Inactive
24 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1215994306
Phone
(401) 767-4163
Address
191 SOCIAL STREET
Deactivation Date
21 June 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4012590340
Graduation Year
2002 (24 years ago)
PAC ID
9436120854
Group Practice PAC ID
7618219544
Professional Enrollment ID
I20040802000200
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

  • 191, Social Street, Social, Woonsocket, Providence County, Rhode Island, 02895, United States

    THUNDERMIST HEALTH CENTER

    WOONSOCKET, RI 02895

    Phone: (401) 767-4163

    Fax: (401) 767-4165

    Type: Mailing

  • 75, Lambert Lind Highway, Pontiac, Warwick, Kent County, Rhode Island, 02886, United States

    QUALITY BEHAVIORAL HEALTH INC

    WARWICK, RI 028861131

    Phone: (401) 681-4274

    Fax: (401) 681-4285

    Type: Location

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 02895)

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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: 7618219544View full group profile
NameSpecialtyState
Physician AssistantTX
Nurse PractitionerRI
Mental Health CounselorRI
Clinical Social WorkerRI
Clinical Social WorkerMA
Mental Health CounselorRI
-WI
P S Y C H I A T R YRI
Nurse PractitionerMA
Mental Health CounselorTN

Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1215994306.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What is Unknown Individual's primary classification?
Psychiatric/Mental Health Clinical Nurse Specialist is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Woonsocket, Rhode Island as a primary anchor for Unknown Individual unless the record lists multiple sites.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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