Active NPI
Sonia Wagner
- Clinical Social Worker
- West Nyack, NY
National Provider Identifier
1114184090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R054917-1
- Practice address
- 719 W Nyack Rd Ste 43
West Nyack, NY 10994-2241 - Phone
- (845) 216-1495
- NPI assigned
- May 19, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R054917-1 | NY | Primary |
Addresses
Primary practice location
719 W Nyack Rd Ste 43
West Nyack, NY 10994-2241
Mailing address
719 W Nyack Rd Ste 43
West Nyack, NY 10994-2241
Phone (845) 216-1495
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 1, 2024 through Nov 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R054917-1 | NY | MD | Clinical Social Worker |
| 054917 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mental Health Association of Rockland County, Inc. | Current | Accepting new patients |
Interoperability endpoints
- swagner@mhar.medalliesdirect.net
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Voluntary or Charitable Agency
- Valley Cottage, NY
- NPI 1326105446
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730764800000",
"number": "1114184090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "719 W NYACK RD STE 43",
"city": "WEST NYACK",
"state": "NY",
"postal_code": "109942241",
"telephone_number": "845-216-1495"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "719 W NYACK RD STE 43",
"city": "WEST NYACK",
"state": "NY",
"postal_code": "109942241",
"telephone_number": "845-216-1495"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "SONIA",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-19",
"last_updated": "2024-11-05",
"certification_date": "2024-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R054917-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Nyack, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.