Shannon Wagner, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

099684 Issued in NY

Practice address

1 Genium PLZ
Schenectady, NY 12304-4607

Phone

(518) 346-1285

NPI assigned

Jul 30, 2021

Last updated

Mar 3, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bright Wood Counseling, LCSW, PLLC

  • Mental Health Counselor
  • Scotia, NY
  • NPI 1821927625
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1013680545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 VERNON BLVD",
            "city": "SCOTIA",
            "state": "NY",
            "postal_code": "123022606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GENIUM PLZ",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123044607",
            "telephone_number": "518-346-1285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "SHANNON",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-30",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "099684",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "099684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Schenectady",
            "affiliation": "N",
            "address_1": "1 Genium Plz",
            "city": "Schenectady",
            "state": "NY",
            "country_code": "US",
            "postal_code": "123044607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Barbara Vossler, LMSW
• Miroslav Vytrisal, MD
• Gurinder Singh Wadhwa, DDS
• Eric M Wagle, M.D.
• Jessica Lynn Wagner, CCC-SLP
• Jessica Wakefield
• Wal-Mart Stores East , LP (Wal-Mart Pharmacy 10-2264)
• Wal-Mart Stores East, LP (Vision Center 30-2264)
• Lelia Walcott
• Jonathan Samuel Waldman, MD

• Social Worker in Schenectady, NY
• Providers in Schenectady, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.