John Wagenknecht Jr., LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7214-123 Issued in WI

Practice address

2925 Mondovi Rd
Eau Claire, WI 54701-6141

Phone

(715) 832-0238

NPI assigned

Dec 4, 2013

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1386115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386115200000",
    "number": "1396176129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6981 TIMBER RIDGE CIR",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547018909",
            "telephone_number": "715-577-7130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 MONDOVI RD",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016141",
            "telephone_number": "715-832-0238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGENKNECHT",
        "first_name": "JOHN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-04",
        "last_updated": "2013-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7214-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2013; 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.