Unknown Individual – Clinical Social Worker, NPI 1740425024

Unknown Individual is a healthcare provider. based in Virginia beach, Virginia. specializing in Clinical Social Worker. They hold a License No. 0904000558 (VA). The NPI Number for Unknown Individual is 1740425024

Main info

Organization
Inactive
56 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1740425024
Phone
(757) 490-0377
Address
281 INDEPENDENCE BLVD STE 326
Deactivation Date
28 August 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7574900377
Graduation Year
1970 (56 years ago)
PAC ID
6002970118
Group Practice PAC ID
8820986953
Professional Enrollment ID
I20090203000713
Data current as of
20 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

  • 326, Independence Boulevard, Pembroke Manor, Virginia Beach, Virginia, 23462, United States

    VIRGINIA BEACH, VA 234622978

    Phone: (757) 490-0377

    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 23462)

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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: 8820986953View full group profile

Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1740425024 on file in the registry.
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.
Where in Virginia is Unknown Individual registered?
Use Virginia Beach, Virginia as the headline location for Unknown Individual here.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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