Holland Victoria Wagner, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

3700 Access Road
Jonesboro, AR 72401

NPI assigned

Dec 9, 2019

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 AR

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Arisa Health, Inc.

  • Community/Behavioral Health Agency
  • Springdale, AR
  • NPI 1437750411

  Social Worker

  Medicare reassignment NPD
• Arisa Health, Inc.

  • Community/Behavioral Health Agency
  • Jonesboro, AR
  • NPI 1306532767
  NPD
• Arisa Health, Inc.

  • Family Medicine Physician
  • Jonesboro, AR
  • NPI 1760187413
  NPD

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

{
    "created_epoch": "1575849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1669019634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2707 BROWNS LANE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "72401",
            "telephone_number": "870-972-4939",
            "fax_number": "870-972-4911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 ACCESS ROAD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "72401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "HOLLAND",
        "middle_name": "VICTORIA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-09",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Sue Wadkins, MHPP
• Valerie Wadlington, MHW
• Tina Wages
• Tara Lisa Waggoner, FNP, APN-BC
• Devon Taylor Wagner, QBHP
• Jim A Wagner, DDS, MS
• Ruthie Wagner
• Wake Up Satisfied PA
• Wal-Mart Stores, Inc. (Vision Center 30-0045)
• Wal-Mart Stores, Inc. (Vision Center 30-0128)

• Clinical Social Worker in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.