Unknown Individual – Clinical Social Worker, NPI 1245207042

Unknown Individual is a healthcare provider. based in Woodbridge, Virginia. specializing in Clinical Social Worker. They hold a License No. 0904001205 (VA). The NPI Number for Unknown Individual is 1245207042

Main info

Organization
Inactive
43 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1245207042
Phone
(703) 491-0652
Address
12890 HARBOR DR
Deactivation Date
31 January 2024

Doctor Profile

Medical School Name
WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
7034910652
Graduation Year
1983 (43 years ago)
PAC ID
5991989998
Professional Enrollment ID
I20110418000110
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

Provider Addresses for Unknown Individual

  • 12890 HARBOR DR

    WOODBRIDGE, VA 22192

    Phone: (703) 491-0652

    Fax: (703) 455-5736

    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 22192)

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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 1245207042.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Woodbridge, Virginia may find Unknown Individual in results; validate coverage separately.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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