Unknown Individual – Clinical Social Worker, NPI 1063554624

Clinical Social Worker

Unknown Individual is a healthcare provider. based in Fredericksburg, Texas. specializing in Clinical Social Worker. They hold a License No. 06859 (TX). The NPI Number for Unknown Individual is 1063554624

Main info

Organization

Inactive

Name

Unknown Individual

NPI

1063554624

Phone

(830) 997-8074

Address

114 CHINABERRY LN

Deactivation Date

5 April 2023

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

Provider Addresses for Unknown Individual

114 CHINABERRY LN
FREDERICKSBURG, TX 786243773
Phone: (830) 997-8074
Fax: (830) 990-0008
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 78624)

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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 1063554624 for Unknown Individual, then check state licensing separately.

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 taxonomy line describes Unknown Individual?

For research purposes, treat Unknown Individual as Clinical Social Worker in this dataset. Clinical services aligned with this taxonomy classification.

Does Unknown Individual list a practice location?

Patients near Fredericksburg, Texas may find Unknown Individual in results; validate coverage separately.

What does 'Individual Provider' mean on this profile?

Entity type tells you whether the number belongs to a person or an organization.