Unknown Individual – Addiction (Substance Use Disorder) Counselor, NPI 1376774802

Unknown Individual is a healthcare provider. based in Minneapolis, Minnesota. specializing in Addiction (Substance Use Disorder) Counselor. They hold a License No. 301434 (MN). The NPI Number for Unknown Individual is 1376774802

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1376774802
Phone
(612) 977-1820
Address
1121 JACKSON ST NE
Deactivation Date
15 February 2023
Data current as of
20 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

  • Jackson St Ne, Northeast Lowry Avenue, Holland, Northeast, Minneapolis, Hennepin County, Minnesota, 55418, United States

    105

    MINNEAPOLIS, MN 554131672

    Phone: (612) 977-1820

    Fax: (612) 236-1701

    Type: Location

  • 73rd Avenue North, Brooklyn Park, Hennepin County, Minnesota, 55445, United States

    BROOKLYN PARK, MN 554291152

    Phone: (612) 977-1820

    Fax: (162) 236-1701

    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.

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.

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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 55413)

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Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1376774802.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Addiction (Substance Use Disorder) Counselor. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Minneapolis, Minnesota as a primary anchor for Unknown Individual unless the record lists multiple sites.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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