Individual provider · Type 1 NPI

Jill Degler Waggoner, M.S.W.

Clinical Social Worker · South Bend, IN

NPI number 1164578589 Active

Practice location

108 N Main St Ste 305
South Bend, IN 46601-1614

Fax (574) 234-3565

Mailing address

1601 Byron Dr
South Bend, IN 46614-2804

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X34001091A (IN)

Clinical Social Worker: 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 interpers…

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About NPI 1164578589

Jill Degler Waggoner, M.S.W.'s National Provider Identifier is 1164578589, issued on Jan 26, 2007. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in South Bend, IN. The record was last updated on Jul 8, 2007.