Individual provider Active NPI

Cynthia Connor Wagenhauser, LISW

  • Social Worker
  • Sylvania, OH
National Provider Identifier
1699813436
Registry record updated Jan 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
I0009674 Issued in OH
Practice address
5600 Monroe St
Sylvania, OH 43560-2731
Phone
(419) 885-1910
NPI assigned
Feb 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X I0009674 OH Primary

Addresses

Primary practice location

5600 Monroe St
Sylvania, OH 43560-2731

Mailing address

5600 Monroe St
Sylvania, OH 43560-2731
Phone (419) 885-1910

Other identifiers 1

IdentifierTypeStateIssuer
11562337OtherCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Deep Roots Family Therapy Current Accepting new patients
Family Service of NW Ohio PastSince Jan 1, 1990 Accepting new patients
Family Service of Northwest Ohio PastSince Jan 1, 1990 Accepting new patients
Elliott & Associates Inc Past Accepting new patients
Family Service of Northwest Ohio PastSince Jan 1, 1990 Accepting new patients

Locations

2600 N Reynolds Rd
Ste 101A
Toledo, OH 43615
Phone (888) 469-2178

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264377600000",
    "number": "1699813436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 MONROE ST",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602731",
            "telephone_number": "419-885-1910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 MONROE ST",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602731",
            "telephone_number": "419-885-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGENHAUSER",
        "first_name": "CYNTHIA",
        "middle_name": "CONNOR",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2010-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I0009674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11562337",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylvania, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2010; 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.