| Kathleen J Wagner Lcsw | |
|
820 Division St Billings MT 59101-2049 | |
| (406) 245-1338 | |
| (406) 294-5226 |
| Full Name | Kathleen J Wagner Lcsw |
|---|---|
| Speciality | Social Worker |
| Location | 820 Division St, Billings, Montana |
| Authorized Official Name and Position | Kathleen Wagner (DIRECTOR) |
| Authorized Official Contact | 4062451338 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kathleen J Wagner Lcsw Po Box 2252 Billings MT 59103-2252 Ph: (406) 245-1338 | Kathleen J Wagner Lcsw 820 Division St Billings MT 59101-2049 Ph: (406) 245-1338 |
| NPI Number | 1013257302 |
|---|---|
| Provider Enumeration Date | 02/22/2013 |
| Last Update Date | 03/18/2013 |
| Medicare PECOS PAC ID | 9830336676 |
|---|---|
| Medicare Enrollment ID | O20130514000759 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013257302 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 785 (Montana) | Primary |
| Provider Name | Kathleen J Wagner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417147984 PECOS PAC ID: 0648367169 Enrollment ID: I20071031000348 |
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