Unknown Individual – Mental Health Counselor, NPI 1063784692

Unknown Individual is a healthcare provider. based in Holdenville, Oklahoma. specializing in Mental Health Counselor. They hold a License No. 3029 (OK). The NPI Number for Unknown Individual is 1063784692

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1063784692
Phone
(405) 379-2823
Address
3324 N 379 RD
Deactivation Date
17 July 2025
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

Provider Addresses for Unknown Individual

  • 3324 N 379 RD

    HOLDENVILLE, OK 748486232

    Phone: (405) 379-2823

    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.

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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 74848)

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Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1063784692 as the unique 10-digit identifier.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Mental Health Counselor in the directory — Clinical services aligned with this taxonomy classification.
Where in Oklahoma is Unknown Individual registered?
Use Holdenville, Oklahoma as the headline location for Unknown Individual here.
Does Unknown Individual accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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