Active NPI
Cindy J Wagner, LCSW
- Social Worker
- Danville, IN
National Provider Identifier
1609801984
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 34003577A
- Practice address
- 258 Meadow Dr
Danville, IN 46122 - Phone
- (317) 718-0605
- Fax
- (317) 718-0720
- NPI assigned
- Jul 12, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 34003577A | IN | Primary |
Addresses
Primary practice location
258 Meadow Dr
Danville, IN 46122
Mailing address
258 Meadow Dr
Danville, IN 46122
Phone (317) 718-0605
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000378933 | Other | ANTHEM BCBS | |
| 11487765 | Other | CAQH |
Other names 1
- Ms. Cindy J Brinkman
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34003577A | IN | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gabra S Gachaw MD PC | Social Worker | Past | Accepting new patients |
| Family Counseling Clinic | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Family Couseling Center
- Mental Health Counselor
- Avon, IN
- NPI 1922199165
-
dba Inter-Act
- Mental Health Counselor
- Danville, IN
- NPI 1023021771
Social Worker
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609801984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "258 MEADOW DR",
"city": "DANVILLE",
"state": "IN",
"postal_code": "46122",
"telephone_number": "317-718-0605",
"fax_number": "317-718-0720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "258 MEADOW DR",
"city": "DANVILLE",
"state": "IN",
"postal_code": "46122",
"telephone_number": "317-718-0605",
"fax_number": "317-718-0720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "CINDY",
"middle_name": "J",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IN",
"license": "34003577A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "000000378933",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "11487765",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CINDY",
"last_name": "BRINKMAN",
"middle_name": "J",
"prefix": "MS.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Danville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.