Unknown Individual – Clinical Social Worker, NPI 1124075080

Unknown Individual is a healthcare provider. based in Fergus falls, Minnesota. specializing in Clinical Social Worker. They hold a License No. 2976 (MN). The NPI Number for Unknown Individual is 1124075080

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1124075080
Phone
(218) 736-8007
Address
712 S CASCADE ST
Deactivation Date
25 October 2022
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

  • Lake Region Healthcare, 712, South Cascade Street, Downtown, Fergus Falls, Otter Tail County, Minnesota, 56537, United States

    FERGUS FALLS, MN 565372913

    Phone: (218) 736-8007

    Fax: (218) 736-8725

    Type: Location

  • 24909, Country Oak Loop, Fergus Falls Township, Otter Tail County, Minnesota, 56537, United States

    FERGUS FALLS, MN 565377502

    Phone:

    Type: Mailing

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.

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 56537)

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Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1124075080 when you need to reference Unknown Individual in forms, claims, or directories.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
What kind of provider is Unknown Individual?
The page reflects Clinical Social Worker for Unknown Individual. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Minnesota?
You will see Fergus Falls, Minnesota on file for Unknown Individual alongside any extra practice locations.
How can I contact Unknown Individual?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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