Kendall Todd Carman-Wagner, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW00005301 Issued in WA

Practice address

1012 S 3Rd St
Dayton, WA 99328-1606

Phone

(509) 382-2531

NPI assigned

Jan 11, 2007

Last updated

Feb 15, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Clinical Social Worker

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Columbia County Hospital DistrictGroup PAC ID 5597653758, 55 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Columbia County Hospital District

  dba Columbia County Health System

  • Critical Access Hospital
  • Dayton, WA
  • NPI 1134128911
  Medicare reassignment Care Compare group NPD
• Columbia County Hospital District

  dba Waitsburg Clinic

  • Rural Health Clinic/Center
  • Waitsburg, WA
  • NPI 1215018346
  NPD
• Columbia County Hospital District

  dba College Place Health Clinic

  • Primary Care Clinic/Center
  • College Place, WA
  • NPI 1851050264
  NPD
• Columbia County Hospital District

  dba Columbia Family Clinic

  • Rural Health Clinic/Center
  • Dayton, WA
  • NPI 1518044551
  NPD (past)
• Jubilee Leadership Academy

  • Community/Behavioral Health Agency
  • Prescott, WA
  • NPI 1477940419
  NPD (past)

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1962552844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 EQUESTRIAN WAY",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993626220",
            "telephone_number": "509-529-1496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 S 3RD ST",
            "city": "DAYTON",
            "state": "WA",
            "postal_code": "993281606",
            "telephone_number": "509-382-2531"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29 Jubilee Cir",
            "address_purpose": "LOCATION",
            "city": "Prescott",
            "state": "WA",
            "postal_code": "993488607",
            "country_code": "US",
            "telephone_number": "509-749-2103 x252",
            "fax_number": "509-749-2076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARMAN-WAGNER",
        "first_name": "KENDALL",
        "middle_name": "TODD",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP00000091",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00005301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• April R Biggs, MD
• Blue Mountain Counseling
• Blue Mountain Counseling of Columbia County (Blue Mountain Counseling)
• Julia Grace Bruce, MSN, RDN, CD
• Jennifer Lea Burnett, NP
• Kathleen A Casseday, ARNP
• Chrisann T Christensen, LMHC
• Sherena Gwenevere Clements, RN
• Columbia County Fire Dist 3
• Columbia County Hospital District (Columbia County Health System)

• Clinical Social Worker in Dayton, WA
• Providers in Dayton, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.