Unknown Individual – Addiction (Substance Use Disorder) Counselor, NPI 1205004512

Unknown Individual is a healthcare provider. based in Vernon, Connecticut. specializing in Addiction (Substance Use Disorder) Counselor. They hold a License No. 000599 (CT). The NPI Number for Unknown Individual is 1205004512

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1205004512
Phone
(860) 978-3595
Address
427 LAKE ST
Deactivation Date
16 October 2024
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 427, Lake Street, Hillsboro, Town of Hillsboro, Vernon County, Wisconsin, 54634, United States

    VERNON, CT 060666326

    Phone: (860) 978-3595

    Type: Mailing

  • 233, Center Street, Hilliardville, Manchester, Hartford County, Connecticut, 06040, United States

    MANCHESTER, CT 06040

    Phone: (860) 978-3595

    Type: Location

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.

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Medicare Enrollment & Revalidation

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No Medicare enrollment or revalidation data available for this provider in our database.

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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 06066)

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Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1205004512 is assigned to Unknown Individual under the national enumeration system.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Addiction (Substance Use Disorder) Counselor. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Vernon, Connecticut for Unknown Individual; expand the address list for detail.
What if Vernon, Connecticut seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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