Unknown Individual – Marriage & Family Therapist, NPI 1720164015

Unknown Individual is a healthcare provider. based in Fort walton beach, Florida. specializing in Marriage & Family Therapist. They hold a License No. MT 1326 (FL). The NPI Number for Unknown Individual is 1720164015

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1720164015
Phone
(850) 862-3772
Address
348 MIRACLE STRIP PKWY SW
Deactivation Date
21 October 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

  • Miracle Strip Pkwy SW, Fort Walton Beach, Okaloosa County, Florida, 32548, United States

    SUITE 3

    FORT WALTON BEACH, FL 325485200

    Phone: (850) 862-3772

    Fax: (850) 863-4574

    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 32548)

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Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1720164015 as the unique 10-digit identifier.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Marriage & Family Therapist. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Fort Walton Beach?
Public fields place Unknown Individual around Fort Walton Beach, Florida. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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