Unknown Individual – Addiction (Substance Use Disorder) Counselor, NPI 1407954506

Unknown Individual is a healthcare provider. based in Beavercreek, Ohio. specializing in Addiction (Substance Use Disorder) Counselor. They hold a License No. 965973 (OH). The NPI Number for Unknown Individual is 1407954506

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1407954506
Phone
(937) 320-0755
Address
3121 EVELYN DR
Deactivation Date
6 December 2023
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

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Provider Addresses for Unknown Individual

  • Evelyn Drive, Zimmerman, Beavercreek, Greene County, Ohio, 45434, United States

    SUITE 110

    BEAVERCREEK, OH 454346382

    Phone: (937) 320-0755

    Fax: (937) 320-1589

    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 45434)

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Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1407954506.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
Does Unknown Individual list a primary specialty?
If you are matching referrals, note Addiction (Substance Use Disorder) Counselor for Unknown Individual. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Beavercreek, Ohio for Unknown Individual; expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.