Individual provider · Type 1 NPI

Kevin Dale Wagner, MSW

Clinical Social Worker · Poplar Bluff, MO

NPI number 1215139894 Active

Practice location

1500 N Westwood Blvd
Poplar Bluff, MO 63901-3318

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700XSW 04619 (MO)

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 1215139894

Kevin Dale Wagner, MSW's National Provider Identifier is 1215139894, issued on Jun 5, 2007. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Poplar Bluff, MO. The record was last updated on Dec 26, 2013.