Christy Taylor Wagner, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C002698 Issued in NC

Practice address

2300 Ramsey St
Fayetteville, NC 28301-3856

Phone

(910) 488-2120

Fax

(910) 482-5099

NPI assigned

Jun 7, 2006

Sex

Female

Sole proprietor

Yes

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

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1629018668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7827 AMESBURY RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283119364",
            "telephone_number": "910-482-4669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 RAMSEY ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283013856",
            "telephone_number": "910-488-2120",
            "fax_number": "910-482-5099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "CHRISTY",
        "middle_name": "TAYLOR",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "775",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C002698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• W a Willis MD PA
• W. H. Kingery DDS PA
• Stacy Lynne Wade, PHARMD
• Tasha Wade, LCSWA
• Kristina Waden
• Stephanie Victoria Wagner, OTR/L
• Anna Montgomery Wagoner, OTD
• Isabella Wagoner
• Sa Lay Wah, MD
• San San Wai, M.D.

• Clinical Social Worker in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; 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.