Nancy Elizabeth Wagner, MSW LCSW LISAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-11534 Issued in AZ

Practice address

2408 E Pecos Rd
Phoenix, AZ 85048-8272

Phone

(480) 329-9688

Fax

(480) 329-9688

NPI assigned

Mar 1, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1295863215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10204 BODE ST STE B",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605859813",
            "telephone_number": "855-241-7160",
            "fax_number": "954-324-8354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2408 E PECOS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850488272",
            "telephone_number": "480-329-9688",
            "fax_number": "480-329-9688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "NANCY",
        "middle_name": "ELIZABETH",
        "credential": "MSW LCSW  LISAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "LISAC-11062",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-11534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Sunset Wagner
• Lori J Wagner, FNP
• Margaret Wagner
• Melissa Chanell Wagner, PHD
• Monica Elaine Wagner, MD
• Ryan Gregory Wagner, MD, MSC(MED), PHD
• Shinnayha Nicole Wagner
• Stacie Wagner, NNP
• Walter Peter Wagner II, D.O.
• Gretchen Marie Wagnitz, MS, LAT, ATC

• Clinical Social Worker in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; 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.