Lisa Elizabeth Wagner, LISW | |
405 N Main St, Kenton, OH 43326-1375 | |
(419) 679-5994 | |
(419) 225-8878 |
Full Name | Lisa Elizabeth Wagner |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 405 N Main St, Kenton, Ohio |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1629182225 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | I0009675 (Ohio) | Primary |
Entity Name | Health Partners Of Western Ohio |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1760952741 PECOS PAC ID: 9436139987 Enrollment ID: O20150313002043 |
Mailing Address | Practice Location Address |
---|---|
Lisa Elizabeth Wagner, LISW 329 N West St, Lima, OH 45801-4332 Ph: (419) 221-3072 | Lisa Elizabeth Wagner, LISW 405 N Main St, Kenton, OH 43326-1375 Ph: (419) 679-5994 |
Mrs. Michelle L Monfort, MSW, LISW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 111 W Espy St, Kenton, OH 43326 Phone: 419-679-5994 Fax: 419-225-8878 | |
Megan L Russell, LISW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 111 W Espy St, Kenton, OH 43326 Phone: 419-679-5994 Fax: 419-225-8878 | |
Patricia Shae Golden, LISW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 111 W Espy St, Kenton, OH 43326 Phone: 419-679-5994 Fax: 419-225-8878 | |
Mrs. Anna Lee Lopez, LISW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 111 W Espy St, Kenton, OH 43326 Phone: 419-679-5994 Fax: 419-225-8878 |