Individual provider Active NPI

Laura K Wagner, LCSW

  • Clinical Social Worker
  • Milwaukee, WI
National Provider Identifier
1881390672
Registry record updated Apr 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11832-123 Issued in WI
Practice address
1032 S Cesar E Chavez Dr
Milwaukee, WI 53204-2203
Phone
(414) 672-1353
Fax
(262) 408-5094
NPI assigned
Feb 2, 2023
Last updated
Apr 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 11832-123 WI Primary

Addresses

Primary practice location

1032 S Cesar E Chavez Dr
Milwaukee, WI 53204-2203

Mailing address

PO Box 778789
Chicago, IL 60677-8089
Phone (414) 672-1353

Other practice location 1

2906 S 20th St
Milwaukee, WI 53215-3732
Phone (414) 672-1353

Other practice location 2

1635 W National Ave
Milwaukee, WI 53204-1130
Phone (414) 672-1353

Other practice location 3

309 E North St
Waukesha, WI 53188-3718
Phone (414) 672-1353

Other practice location 4

4570 S 27th St
Milwaukee, WI 53221-2145
Phone (414) 672-1353

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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

Enrollment IDStateProvider typePAC IDDetails
I20251021000422 WI Practitioner - Clinical Social Worker 2365930542 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Washington University School of Medicine, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1032 S Cesar E Chavez Dr
Milwaukee, WI 53204-2203

PO Box
Chicago, IL 60677

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11832-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sixteenth Street Community Health Centers, Inc. CurrentSince Sep 15, 2025 Accepting new patients
16TH Street Community Health Center Inc. Current Accepting new patients
Sixteenth Street Community Health Centers, Inc. CurrentSince Sep 15, 2025 Accepting new patients

Locations

1032 S Cesar E Chavez Dr
Milwaukee, WI 53204

1635 W National Ave
Milwaukee, WI 53204
Phone (262) 408-5094

2906 S 20th St
Milwaukee, WI 53215
Phone (414) 385-8800

4570 S 27th St
Milwaukee, WI 53221
Phone (414) 325-8720

309 E North St
Waukesha, WI 53188
Phone (262) 408-2530

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1675296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775001600000",
    "number": "1881390672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 778789",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606778089",
            "telephone_number": "414-672-1353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1032 S CESAR E CHAVEZ DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532042203",
            "telephone_number": "414-672-1353",
            "fax_number": "262-408-5094"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2906 S 20th St",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532153732",
            "country_code": "US",
            "telephone_number": "414-672-1353",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1635 W National Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532041130",
            "country_code": "US",
            "telephone_number": "414-672-1353",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "309 E North St",
            "address_purpose": "LOCATION",
            "city": "Waukesha",
            "state": "WI",
            "postal_code": "531883718",
            "country_code": "US",
            "telephone_number": "414-672-1353",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4570 S 27th St",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532212145",
            "country_code": "US",
            "telephone_number": "414-672-1353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "LAURA",
        "middle_name": "K",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-02",
        "last_updated": "2026-04-01",
        "certification_date": "2026-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "11832-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.