Kimberly Jean Golding Wagner, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

073383 Issued in NY

Practice address

1519 Nye Road
Lyons, NY 14489

Phone

(315) 946-5722

Fax

(315) 946-5726

NPI assigned

Jul 25, 2007

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 identifiers 1

Other names 1

• Ms. Kimberly Jean Golding Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185321600000",
    "number": "1285834499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1519 NYE ROAD",
            "city": "LYONS",
            "state": "NY",
            "postal_code": "14489",
            "telephone_number": "315-946-5722",
            "fax_number": "315-946-5726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1519 NYE ROAD",
            "city": "LYONS",
            "state": "NY",
            "postal_code": "14489",
            "telephone_number": "315-946-5722",
            "fax_number": "315-946-5726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "KIMBERLY",
        "middle_name": "JEAN GOLDING",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-25",
        "last_updated": "2007-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "073383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00357502",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "GOLDING",
            "middle_name": "JEAN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• William Nicholas Van Horn, PMHNP
• Timothy Ryan Vanduyne, CASAC-T, LPN
• Karen Visco, RN
• Tammie Vivlamore, CRPA-P
• Morgan Wadsworth
• Kyle Wagner
• Lisa Ann Warner, LPN ASSOC SOCIAL SER
• Thomas Dean Wasser, MD
• Wayne County (Wayne County Public Health)
• Wayne County Action Program, Inc.

• Social Worker in Lyons, NY
• Providers in Lyons, 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 Jul 25, 2007; 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.