Unknown Individual – Clinical Social Worker, NPI 1023592078

Clinical Social Worker

Unknown Individual is a healthcare provider. based in Lake forest park, Washington. specializing in Clinical Social Worker. They hold a License No. 60169860 (WA). The NPI Number for Unknown Individual is 1023592078

Main info

Organization

Inactive

38 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1023592078

Phone

Not provided

Address

14816 BOTHELL WAY NE APT 138

Deactivation Date

4 September 2025

Doctor Profile

Medical School Name

OTHER

Secondary Phone

2064025767

Graduation Year

1988 (38 years ago)

PAC ID

4183051162

Group Practice PAC ID

4981872561

Professional Enrollment ID

I20200304001306

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

Loading map...

Provider Addresses for Unknown Individual

14816 BOTHELL WAY NE APT 138
LAKE FOREST PARK, WA 981557639
Phone:
Type: Mailing
Northeast 85th Street, Redmond, King County, Washington, 980452, United States
REDMOND, WA 980523546
Phone: (425) 558-0558
Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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 98155)

Loading plans...

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: 4981872561View full group profile

Name	Specialty	State
CARMEN C BERZINSKI (LICSW)	Clinical Social Worker	MN
MS. NICHOLE L JARDINE (LCSW)	Clinical Social Worker	UT
GWENDOLYN SILVER (LICSW)	Clinical Social Worker	WA
LYNN HACKSTAFF (LICSW)	-	CA
DEBRA RICE	Nurse Practitioner	WA
MATTHEW W CRONIN (MA, LMHC, PCA)	Mental Health Counselor	WA
SHANNON MICHELLE EATON (MSN, FPMHNP, PMHNP)	Nurse Practitioner	OR
DR. MORGAN RAE NEGAARD (DNP, APRN, PMHNP-BC)	-	WA
CINDY L. GILBERT (LICSW)	-	WA
MICHELE GILES ROMERO (APRN)	Nurse Practitioner	MA

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What is the registry number for Unknown Individual?

The registry entry for Unknown Individual shows NPI 1023592078.

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 does the directory say Unknown Individual does?

Insurance directories may phrase it differently, but here Unknown Individual maps to Clinical Social Worker. Clinical services aligned with this taxonomy classification.

Is Unknown Individual tied to Lake Forest Park, Washington?

If you are local to Lake Forest Park, Washington, Unknown Individual may be relevant to your search.

Who maintains Unknown Individual's record?

Providers certify NPPES data; CMS hosts the public file you are viewing.