Unknown Individual – Clinical Social Worker, NPI 1407824550

Unknown Individual is a healthcare provider. based in Johnson city, Tennessee. specializing in Clinical Social Worker. They hold a License No. 3911 (TN). The NPI Number for Unknown Individual is 1407824550

Main info

Organization
Inactive
34 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1407824550
Phone
(423) 283-4958
Address
2 REDBUSH CT
Deactivation Date
2 August 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4232834958
Graduation Year
1992 (34 years ago)
PAC ID
0941101414
Professional Enrollment ID
I20040116000953
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

  • Redbush, Johnson County, Kentucky, 41226, United States

    SUITE 2

    JOHNSON CITY, TN 376014340

    Phone: (423) 283-4958

    Fax: (423) 283-7135

    Type: Location

  • Johnson City Post Office, 201, South Avenue G, Johnson City, Blanco County, Texas, 78636, United States

    JOHNSON CITY, TN 376023534

    Phone: (423) 283-4958

    Fax: (423) 283-7135

    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.

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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 37601)

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Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1407824550 when you need to reference Unknown Individual in forms, claims, or directories.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual's primary listing?
We display Johnson City, Tennessee because that is what the record indicates for Unknown Individual.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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