Unknown Individual – Counselor, NPI 1205901436

Unknown Individual is a healthcare provider. based in Gray, Tennessee. specializing in Counselor. They hold a License No. LDP410 (TN). The NPI Number for Unknown Individual is 1205901436

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1205901436
Phone
(423) 467-3600
Address
PO BOX 9054
Deactivation Date
20 March 2024
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

  • Gray Post Office, Main Street, Gray, Lincoln Township, Audubon County, Iowa, 50110, United States

    GRAY, TN 376159054

    Phone: (423) 467-3600

    Fax: (423) 467-3696

    Type: Mailing

  • 109, West Watauga Avenue, N C Love Addition, Johnson City, Washington County, Tennessee, 37604, United States

    JOHNSON CITY, TN 37604

    Phone: (423) 232-2606

    Fax: (423) 232-2646

    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 37615)

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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 1205901436.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Counselor. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Gray, Tennessee 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.