Miranda Wagnitz

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

S.1701300 Issued in OH

Practice address

680 Park Ave W
Mansfield, OH 44906-3706

Phone

(419) 528-5993

NPI assigned

Oct 20, 2022

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

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": "1666224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1316664360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 PARK AVE W",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449063706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 PARK AVE W",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449063706",
            "telephone_number": "419-528-5993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNITZ",
        "first_name": "MIRANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-20",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.1701300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blake Douglas Wagner Jr., PH.D.
• Brandon Wagner
• Catherine Marie Wagner, STNA
• Jessica Wagner, PA-C
• Meghan Wagner, LPCC
• Lyneal Marie Wainwright, LICDC
• Jill A Waite, LPCC-S
• Elizabeth Bailey Wakefield, D.P.M.
• Tessie S Wakefield, MA CCCSLP
• Wal-Mart Stores East LP

• Clinical Social Worker in Mansfield, OH
• Providers in Mansfield, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; 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.