Marcella Wagner, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C014114 Issued in NC

Practice address

2009 Chapel Hill Rd
Durham, NC 27707-1109

Phone

(919) 699-9508

NPI assigned

Mar 22, 2018

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Mar 12, 2019 through Mar 12, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1521676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1699279745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5509 QUAIL HOLLOW DR",
            "city": "HILLSBOROUGH",
            "state": "NC",
            "postal_code": "272789121",
            "telephone_number": "919-699-9508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2009 CHAPEL HILL RD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277071109",
            "telephone_number": "919-699-9508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "MARCELLA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-22",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C014114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Wadleigh, LCMHCA
• Adrienne P Wagenblast, RN MS CDE
• Anushri Kushwaha Wagner, DO
• Jacob Lewis Wagner, DO
• Lia Wagner
• Martha E Wagner, RN
• Sheenagh Lopez Wagner
• Lorraine L Waguespack, F.N.P.
• Kerri Margret Wahl, M.D.
• Karen Mary Wahle

• Clinical Social Worker in Durham, NC
• Providers in Durham, 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 Oct 19, 2022; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.