Alicia Wagner Counseling LLC

Organization Active NPI Clinical Social Worker · Norfolk, NE

NPI 1619746286 · NPPES record last updated Dec 25, 2023

Key facts

NPI
1619746286
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Social Worker 1041C0700X
Legal business name
ALICIA WAGNER COUNSELING LLC
Practice address
1909 Vicki LN Ste 105
Norfolk, NE 68701-4542
Phone
(402) 256-7883
NPI assigned
Dec 25, 2023
Organization subpart
No

Authorized official

Name
Alicia Wagner, LIMHP, LCSW, LADC
Title
Owner
Phone
(402) 256-7883

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NE

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20240205003057 NE Part B Supplier - Clinic/Group Practice 2769825991 Receives reassigned benefits from 1 practitioner
Practice locations: Norfolk, NE

National Provider Directory

Locations

710 S 13th St
Ste 900
Norfolk, NE 68701
Phone (402) 640-7521

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker
Group: 193400000X SINGLE SPECIALTY GROUP
1041C0700X Yes

Addresses

Primary practice location

1909 Vicki LN Ste 105
Norfolk, NE 68701-4542

Mailing address

710 S. 13TH St.
Ste 900 PMB 238
Norfolk, NE 68701
Phone (402) 256-7883

Other providers in Norfolk, NE

All providers in Norfolk, NE · Clinical Social Worker in Nebraska

Sources for this page

Verify at the official NPI Registry.