Unknown Individual – Mental Health Counselor, NPI 1104997576

Unknown Individual is a healthcare provider. based in Wilder, Kentucky. specializing in Mental Health Counselor. They hold a License No. 103351 (KY). The NPI Number for Unknown Individual is 1104997576

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1104997576
Phone
(859) 572-0400
Address
519 Licking Pike
Deactivation Date
18 September 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 519 Licking Pike

    Wilder, KY 41071

    Phone: (859) 572-0400

    Fax: (859) 442-3363

    Type: Location

  • Boom Box Buns, 1324, Main Street, Main Street Business District, Over-the-Rhine, Cincinnati, Hamilton County, Ohio, 45202, United States

    CINCINNATI, OH 452635283

    Phone: (859) 301-5901

    Fax: (859) 301-5940

    Type: Mailing

  • 334, Thomas More Parkway, Crestview Hills, Kenton County, Kentucky, 41017, United States

    CRESTVIEW HILLS, KY 41017

    Phone: (859) 301-5901

    Fax: (859) 301-5940

    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

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.

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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 41071)

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Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1104997576 when you need to reference Unknown Individual in forms, claims, or directories.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Mental Health Counselor. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Kentucky?
You will see Wilder, Kentucky on file for Unknown Individual alongside any extra practice locations.
What if Wilder, Kentucky seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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