Active NPI
Caroljean Wagener, MSW, LCSW, LCAC
- Clinical Social Worker
- Indianapolis, IN
National Provider Identifier
1932228772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 34003291A
- Practice address
- 8300 South Meridian Street
Indianapolis, IN 46227-4943 - Phone
- (317) 881-8711
- NPI assigned
- Mar 29, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 87001133A | IN | |
| Clinical Social Worker | 1041C0700X | 34003291A | IN | Primary |
Addresses
Primary practice location
8300 South Meridian Street
Indianapolis, IN 46227-4943
Mailing address
8300 South Meridian Street
Indianapolis, IN 46227-4943
Phone (317) 881-8711
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 87001133A | IN | MD | Addiction (Substance Use Disorder) Counselor |
| 34003291A | IN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329091200000",
"number": "1932228772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8300 SOUTH MERIDIAN STREET",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462274943",
"telephone_number": "317-881-8711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8300 SOUTH MERIDIAN STREET",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462274943",
"telephone_number": "317-881-8711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGENER",
"first_name": "CAROLJEAN",
"name_prefix": "Ms.",
"credential": "MSW, LCSW, LCAC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-29",
"last_updated": "2012-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "IN",
"license": "87001133A",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34003291A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.