VIRGINIA YVONNE WAGNER (NPI# 1225539398) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225539398 |
| Entity Type | Individual |
| Full Name | VIRGINIA YVONNE WAGNER |
| Practice Address |
400 N Pleasant Ave Centralia IL 62801-3056 |
| Mailing Address |
928 W 4th St Centralia IL 62801-5718 |
| Practice Telephone | 6184378692 |
| Practice Fax Number | 6184366420 |
| Mailing Telephone | 6185323558 |
| Mailing Fax Number | 6184366420 |
| Enumeration Date | 2018-02-23 |
| Last Update Date | 2018-02-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
149.006812 | IL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336508662 | Virginia R Wagner | Dietitian, Registered | 2222 Cherry St., Mob 2, M900, Toledo, OH 43608-2801 | 2016-02-15 |
| 1588684609 | Virginia Wagner | Pediatrics | 3310 Magnolia St, Orangeburg, SC 29115-1466 | 2006-07-20 |
| 1891720561 | Virginia Lee Wagner | Social Worker | 1 Jefferson Barracks Rd, Saint Louis, MO 63125-4181 | 2006-07-11 |
| 1124074315 | Virginia Wagner | Physician Assistant | 9000 W Wisconsin Ave, Pediatric Emergency Medicine, Milwaukee, WI 53226-4874 | 2006-05-26 |
| Street Address |
400 N PLEASANT AVE |
| City | CENTRALIA |
| State | IL |
| Zip Code | 62801-3056 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083617245 | St Mary's Hospital, Centralia, Illinois | Psychiatric Unit | 400 N Pleasant Ave, Centralia, IL 62801 | 2005-05-23 |
| 1538649967 | Dana Leigh Trame | Nurse Practitioner | 400 N Pleasant Ave, Centralia, IL 62801-3056 | 2018-08-15 |
| 1487132387 | Brandy Harrison | Nurse Practitioner | 400 N Pleasant Ave, Centralia, IL 62801-3056 | 2018-08-02 |
| 1588105654 | Jana Tull | Nurse Practitioner | 400 N Pleasant Ave, Centralia, IL 62801-3056 | 2017-03-09 |
| 1477097871 | St. Mary's Hospital, Centralia, Illinois | Anesthesiology | 400 N Pleasant Ave, Centralia, IL 62801-3056 | 2016-12-05 |
| 1770031841 | Barbara Dawn Becker | Nurse Practitioner | 400 N Pleasant Ave, Centralia, IL 62801-3056 | 2016-09-16 |
| 1831534460 | Gopinath Gorthy | Psychiatry & Neurology | 400 N Pleasant Ave, Centralia, IL 62801-3056 | 2013-05-09 |
| 1982930079 | Linda D Bryan | Speech-Language Pathologist | 400 N Pleasant Ave, Centralia, IL 62801-3056 | 2009-10-23 |
| 1710105192 | St. Mary's Hospital, Centralia, Illinois | Clinic/Center | 400 N Pleasant Ave, Centralia, IL 62801 | 2007-04-23 |
| 1083750632 | Beth Fadler | Physical Therapist | 400 N Pleasant Ave, Centralia, IL 62801-3056 | 2007-01-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356996151 | Matthew Crawford | Counselor | 904 E Martin Luther King Dr, Centralia, IL 62801 | 2019-08-08 |
| 1588130314 | Kennah White | Counselor | 904 E. Mlk Drive, Centralia, IL 62801 | 2018-10-19 |
| 1245721588 | Lindsey Nicole Fogliasso | Counselor | 904 East Mlk Dr., Centralia, IL 62801 | 2018-05-22 |
| 1629573365 | Prabhat Shrestha | Student in an Organized Health Care Education/Training Program | 605 Sable Drive, Centralia, IL 62801 | 2018-03-26 |
| 1619496098 | Whitney Rathmann | Speech-Language Pathologist | 224 South Locust, Centralia, IL 62801 | 2017-09-17 |
| 1376082685 | Athena A Smith | Counselor | 904 E. Martin Luther King Dr, Centralia, IL 62801 | 2017-02-20 |
| 1447704069 | Meghan Branch | Counselor | 904 Martin Luther King Dr, Centralia, IL 62801 | 2016-08-11 |
| 1568820637 | Midland Area Agency On Aging | Case Management | 434 S Poplar Street, Centralia, IL 62801 | 2016-02-04 |
| 1104201714 | Keri Douglas | Nurse Practitioner | 1054 M. L. King Drive #125, Centrailia, IL 62801 | 2015-07-24 |
| 1215331509 | Melissa Dane | Counselor | 904 E Martin Luther King Dr., Centralia, IL 62801 | 2014-10-15 |
| Find all providers in zip 62801 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104427715 | Jerald Rodman | Social Worker | 2565 Kristine Ct, Centralia, WA 98531-8808 | 2020-11-02 |
| 1407463706 | Allison Nichole Kemble | Social Worker | 806 Shawn Ct, Centralia, MO 65240-4320 | 2020-09-30 |
| 1801398334 | Destin Lloyd Mays | Social Worker | 601 E Calumet St, Centralia, IL 62801-4549 | 2018-02-28 |
| 1457698912 | Washington Cisco | Social Worker | 2870 E Jefferson St, Centralia, IL 62801-8530 | 2013-01-03 |
| 1982901930 | Karen Diane Brunson | Social Worker | 206 Centralia College Blvd, Centralia, WA 98531-4007 | 2011-02-26 |
| 1619278033 | Sara Michele Lahman | Social Worker | 810 E Chris Ct, Centralia, MO 65240-3787 | 2010-11-17 |
| 1629139993 | Lynette M Sexton | Social Worker | 625 S Diamond St, Centralia, WA 98531-3817 | 2006-12-12 |
| 1710060546 | Dale H Spitler | Social Worker | 1424 Nelms Ave, Centralia, IL 62801-4935 | 2006-10-23 |
| 1134155625 | Sally Johonna Lindsay | Social Worker | 904 E. Martin Luther King Dr., Centralia, IL 62801-3506 | 2006-06-25 |
| 1083696876 | Jerome Merle Wasson | Social Worker | 206 W Locust St, Centralia, WA 98531-4007 | 2005-11-17 |
| Find all providers in CENTRALIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.