Active NPI
Ian Jeffrey Agar, MSW, LCSW, CADC III
- Clinical Social Worker
- Wausau, WI
National Provider Identifier
1265537484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 7098-123
- Practice address
- Wausau Veterans Outpatient Clinic
515 S. 32ND Avenue
Wausau, WI 54401 - Phone
- (715) 842-2834
- Fax
- (715) 845-8211
- NPI assigned
- Sep 13, 2006
- Last updated
- May 8, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 13523 | WI | |
| Clinical Social Worker | 1041C0700X | 7098-123 | WI | Primary |
Addresses
Primary practice location
Wausau Veterans Outpatient Clinic
515 S. 32ND Avenue
Wausau, WI 54401
Mailing address
W15354 County Highway D
Witttenberg, WI 54499
Phone (715) 793-4411
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13523 | WI | MD | Addiction (Substance Use Disorder) Counselor |
| 7098-123 | WI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399507200000",
"number": "1265537484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W15354 COUNTY HIGHWAY D",
"city": "WITTTENBERG",
"state": "WI",
"postal_code": "54499",
"telephone_number": "715-793-4411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "WAUSAU VETERANS OUTPATIENT CLINIC",
"address_2": "515 S. 32ND AVENUE",
"city": "WAUSAU",
"state": "WI",
"postal_code": "54401",
"telephone_number": "715-842-2834",
"fax_number": "715-845-8211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AGAR",
"first_name": "IAN",
"middle_name": "JEFFREY",
"name_prefix": "Mr.",
"credential": "MSW, LCSW, CADC III",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-13",
"last_updated": "2014-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WI",
"license": "13523",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "7098-123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wausau, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.