Robert F Waggener, M.DIV, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

4069 Issued in LA

Practice address

11914 Justice Ave
Baton Rouge, LA 70816-2372

Phone

(225) 291-4282

Fax

(225) 291-7133

NPI assigned

Sep 15, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Mr. Bob Waggener Professional name

Medicare fee-for-service enrollment

Enrolled in LA

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

Specialty

Clinical Social Worker

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Jubilee Counseling LLC

  • Social Worker
  • Daphne, AL
  • NPI 1821489980
  NPD (past)

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1275639858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11914 JUSTICE AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708162372",
            "telephone_number": "225-291-4282",
            "fax_number": "225-291-7133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11914 JUSTICE AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708162372",
            "telephone_number": "225-291-4282",
            "fax_number": "225-291-7133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGGENER",
        "first_name": "ROBERT",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "M.DIV, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "4069",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC CLINICAL SW",
            "identifier": "4069",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMER ASS PASTORAL COUNSE",
            "identifier": "6241",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BOB",
            "last_name": "WAGGENER",
            "prefix": "MR.",
            "credential": "M.DIV, LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Lawrence Durell Wade, M.D., LLC
• Morgan Wade, CIT
• Shelette Wade
• Shirley Freeman Wade, FNP-C
• Trais D Wade
• Mark J Waggenspack, MD
• Wame Nicholas Waggenspack Jr., M.D.
• Jessica Waggoner
• Brittany Wagner, D.O.
• Emily Lanier Wagner, PA

• Clinical Social Worker in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Clinical Social Worker in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.