Individual provider · Type 1 NPI

Virginia Yvonne Wagner

Clinical Social Worker · Centralia, IL

NPI number 1225539398 Active

Practice location

400 N Pleasant Ave
Centralia, IL 62801-3056

Call (618) 437-8692 Map

Fax (618) 436-6420

Mailing address

928 W 4th St
Centralia, IL 62801-5718

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X149.006812 (IL)

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 1225539398

Virginia Yvonne Wagner's National Provider Identifier is 1225539398, issued on Feb 23, 2018. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Centralia, IL. The record was last updated on Feb 23, 2018.