Unknown Individual – Clinical Social Worker, NPI 1508066929

Unknown Individual is a healthcare provider. based in Edina, Minnesota. specializing in Clinical Social Worker. They hold a License No. 4079 (MN). The NPI Number for Unknown Individual is 1508066929

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1508066929
Phone
(952) 848-1722
Address
5836 ABBOTT AVE S
Deactivation Date
9 October 2025
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

  • 5836, Abbott Avenue South, Edina, Hennepin County, Minnesota, 55410, United States

    EDINA, MN 554102810

    Phone: (952) 848-1722

    Fax: (952) 996-2058

    Type: Mailing

  • Crosstown Drive Northwest, Andover, Anoka County, Minnesota, 55304, United States

    ANDOVER, MN 553045853

    Phone: (763) 482-9598

    Fax: (763) 482-9598

    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.

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 55410)

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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 1508066929.
Is Unknown Individual excluded from programs when inactive?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Edina, Minnesota in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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