Unknown Individual – Clinical Social Worker, NPI 1215911664

Unknown Individual is a healthcare provider. based in Roanoke, Virginia. specializing in Clinical Social Worker. They hold a License No. 0904001635 (VA). The NPI Number for Unknown Individual is 1215911664

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1215911664
Phone
(540) 772-8043
Address
4656 BRAMBLETON AVE
Deactivation Date
30 December 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

  • 4656, Brambleton Avenue, Mount Vernon Forest, Cave Spring, Roanoke County, Virginia, 24018, United States

    ROANOKE, VA 240183437

    Phone: (540) 772-8043

    Fax: (540) 772-8242

    Type: Mailing

  • 508, East Main Street, Whitefield, Salem, Virginia, 24153, United States

    SALEM, VA 241534319

    Phone: (540) 772-8043

    Fax: (540) 772-8242

    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 24018)

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Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1215911664?
NPI 1215911664 belongs to Unknown Individual; compare other details if you need extra assurance.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Roanoke, Virginia as the reference point for Unknown Individual, then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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