Unknown Individual – Clinical Social Worker, NPI 1114948411

Unknown Individual is a healthcare provider. based in Bennington, Vermont. specializing in Clinical Social Worker. They hold a License No. 089-0000803 (VT). The NPI Number for Unknown Individual is 1114948411

Main info

Organization
Inactive
47 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1114948411
Phone
(802) 442-5491
Address
100 LEDGEHILL RD
Deactivation Date
25 January 2023

Doctor Profile

Medical School Name
UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Secondary Phone
8024425491
Graduation Year
1979 (47 years ago)
PAC ID
3577635796
Group Practice PAC ID
0648226167
Professional Enrollment ID
I20080703000396
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 100, Ledgehill Road, Bennington, Bennington County, Vermont, 05201, United States

    BENNINGTON, VT 052012273

    Phone: (802) 442-5491

    Fax: (802) 442-4910

    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.

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 05201)

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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: 0648226167View full group profile
NameSpecialtyState
Clinical PsychologistVT
-VT
Clinical Social WorkerVT
Mental Health CounselorVT
Mental Health CounselorVT
Nurse PractitionerVT
Certified Clinical Nurse Specialist (Cns)VT
P S Y C H I A T R YVT
Clinical Social WorkerVT
Nurse PractitionerVT

Reviews

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Frequently asked questions

What identifier follows Unknown Individual across health systems?
The NPI 1114948411 uniquely identifies Unknown Individual in U.S. healthcare data.
What does inactive NPI status mean for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Bennington, Vermont?
If you are local to Bennington, Vermont, Unknown Individual may be relevant to your search.
Why is information missing for Unknown Individual?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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