Jeanne Wagner, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C002537 Issued in NC

Practice address

15 Wysteria Way
Chapel Hill, NC 27514-1637

Phone

(919) 933-8840

NPI assigned

Mar 13, 2007

Sex

Female

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

Enrolled in NC

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

Other, 1988

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

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629101167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 WYSTERIA WAY",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275141637",
            "telephone_number": "919-933-8840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 WYSTERIA WAY",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275141637",
            "telephone_number": "919-933-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "JEANNE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C002537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jocelyn Sze Vuong, MD
• Lauren Nicole Waddell, M.A. CF-SLP
• Megan Taylor Wade, MD
• George Lane Wagaman Jr., ED.D.
• Bonnie Alexander Wagner, PA-C, RDN
• Jolynn Marie Wagner, DPT
• Richard W Wagner Jr., DMD
• Sandra M Wagner, PA-C
• Shaun R. Wagner, D.O.
• Sibyl Maureen Wagner, MSW, LCSW

• Clinical Social Worker in Chapel Hill, NC
• Providers in Chapel Hill, 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 Jul 8, 2007; 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.