Candace Jean Neis-Wagner, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7566-123 Issued in WI

Practice address

3040 N 117TH St Ste 100
Wauwatosa, WI 53222-4128

Phone

(414) 337-8988

Fax

(414) 479-0230

NPI assigned

Mar 12, 2010

Last updated

Oct 31, 2023By 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 1

Addresses

Other names 1

• Candace Jean Neis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Children's Health System

  dba Children's Urgent Care - Good Hope

  • Urgent Care Clinic/Center
  • Milwaukee, WI
  • NPI 1861896029
  NPD (past)
• Children's Hospital and Health System, Inc.

  • Urgent Care Clinic/Center
  • Milwaukee, WI
  • NPI 1992713531
  NPD (past)

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

{
    "created_epoch": "1268352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1114240579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3040 N 117TH ST STE 100",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532224128",
            "telephone_number": "414-337-8988",
            "fax_number": "414-479-0230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 N 117TH ST STE 100",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532224128",
            "telephone_number": "414-337-8988",
            "fax_number": "414-479-0230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEIS-WAGNER",
        "first_name": "CANDACE",
        "middle_name": "JEAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-12",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7566-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CANDACE",
            "last_name": "NEIS",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Samantha Kathryn Navins, PT, DPT
• Margaret Anne Nealon, MSW
• Jaimee Victoria Neben, M.D.
• Neeraj Agrawal Clinic LTD
• Michele L. Neils, P.T.
• Sarah Neller
• Katharine Nelson Suwalski, DDS
• Anthony Carl Nelson, M.D.
• Melvin Ruthford Nelson, PHD
• Patricia Kay Nelson, APNP

• Clinical Social Worker in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.