Diane Marie Wagner, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1625 Issued in NE

Practice address

4701 Van Dorn St
Lincoln, NE 68506-2562

Phone

(402) 420-2650

NPI assigned

Aug 28, 2016

Sex

Female

Sole proprietor

No

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

Enrolled in NE

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

University of Nebraska College of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

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.

• Infinite Change Family Therapy Center LLC

  • Mental Health Counselor
  • Lincoln, NE
  • NPI 1093295065
  Medicare reassignment
• Genesis Psychiatric Group, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Lincoln, NE
  • NPI 1740679463
  NPD (past)
• Melissa Renee Sebek

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lincoln, NE
  • NPI 1902201007
  NPD (past)

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

{
    "created_epoch": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472342400000",
    "number": "1366998528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 VAN DORN ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685062562",
            "telephone_number": "402-420-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 VAN DORN ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685062562",
            "telephone_number": "402-420-2650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "DIANE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-28",
        "last_updated": "2016-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "4711",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "1625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Wagner
• Amy R Wagner
• Barbara A Wagner, PT
• Chelcy Wagner
• Christal L Wagner, MS, LPC
• Molly Wagner
• Nicole Wagner
• Spencer Ray Wagner, DPT, PT
• Tanya Wagner, RD
• Teresa Wagner

• Clinical Social Worker in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Clinical Social Worker in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2016; 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.