Unknown Individual – Adult Psychiatric/Mental Health Clinical Nurse Specialist, NPI 1609869320

Unknown Individual is a healthcare provider. based in Brookhaven, Pennsylvania. specializing in Adult Psychiatric/Mental Health Clinical Nurse Specialist. They hold a License No. RN179101L (PA). The NPI Number for Unknown Individual is 1609869320

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1609869320
Phone
(610) 876-4611
Address
3428 WASHINGTON AVE
Deactivation Date
22 October 2021
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

  • 3428, Washington Avenue, Brookhaven, Delaware County, Pennsylvania, 19015, United States

    BROOKHAVEN, PA 190152732

    Phone: (610) 876-4611

    Type: Mailing

  • 16, West Front Street, Media, Delaware County, Pennsylvania, 19063, United States

    SUITE 2

    MEDIA, PA 190633306

    Phone: (610) 565-1129

    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.

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 19015)

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Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1609869320 for Unknown Individual, then check state licensing separately.
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 taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Adult Psychiatric/Mental Health Clinical Nurse Specialist in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Brookhaven, Pennsylvania as a primary anchor for Unknown Individual unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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