Unknown Individual – Mental Health Counselor, NPI 1205827102

Unknown Individual is a healthcare provider. based in Springfield, Ohio. specializing in Mental Health Counselor. They hold a License No. E4359 (OH). The NPI Number for Unknown Individual is 1205827102

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1205827102
Phone
(937) 399-9500
Address
1345 N FOUNTAIN BLVD
Deactivation Date
15 August 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

  • 1345, North Fountain Boulevard, Ridgewood, Springfield, Clark County, Ohio, 45504, United States

    SPRINGFIELD, OH 455041422

    Phone: (937) 399-9500

    Fax: (937) 399-2701

    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 45504)

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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 1205827102.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Mental Health Counselor in this dataset. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Springfield, Ohio in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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