Unknown Individual – Clinical Social Worker, NPI 1235109679

Unknown Individual is a healthcare provider. based in Boulder, Colorado. specializing in Clinical Social Worker. They hold a License No. 979015 (CO). The NPI Number for Unknown Individual is 1235109679

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1235109679
Phone
(303) 517-9830
Address
3450 PENROSE PL
Deactivation Date
27 December 2023
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

  • 3450, Penrose Place, Boulder, Boulder County, Colorado, 80301, United States

    SUITE 210

    BOULDER, CO 803011828

    Phone: (303) 517-9830

    Fax: (303) 444-0256

    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 80301)

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Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1235109679 for Unknown Individual.
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.
Can patients visit Unknown Individual in Boulder, Colorado?
For routing, start with Boulder, Colorado for Unknown Individual, then verify phone and hours locally.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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