Unknown Individual – Mental Health Counselor, NPI 1104986694

Unknown Individual is a healthcare provider. based in Erie, Pennsylvania. specializing in Mental Health Counselor. They hold a License No. PC000402 (PA). The NPI Number for Unknown Individual is 1104986694

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1104986694
Phone
(814) 836-0936
Address
3939 W RIDGE RD
Deactivation Date
10 July 2024
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

  • West Ridge Road, Girard Township, Erie County, Pennsylvania, 16417, United States

    ERIE, PA 165061879

    Phone: (814) 836-0936

    Type: Location

  • 4210, Bear Creek Road, Walnut Heights, Fairview Township, Erie County, Pennsylvania, 16415, United States

    FAIRVIEW, PA 164152017

    Phone: (814) 474-3572

    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.

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Medicare Enrollment & Revalidation

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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 16506)

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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 1104986694.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Mental Health Counselor. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Erie, Pennsylvania for Unknown Individual; expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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