Wagner, Carol Theresa
Wagner, Carol Theresa is an sole proprietor health care provider with primary practice located at 2780 Schurz Ave , Bronx NY 10465-3234. She recently has 6 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Pastoral, Behavioral Health & Social Service Providers / School, Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Wagner, Carol Theresa can be contacted via phone (718) 863-9134.Contact Information
Primary practice address
2780 Schurz Ave
Bronx NY 10465-3234
Phone: (718) 863-9134
Fax: (718) 863-6125
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | ||
| Behavioral Health & Social Service Providers / Pastoral | 101YP1600X | ||
| Behavioral Health & Social Service Providers / School | 101YS0200X | ||
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | ||
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | PR029268-1 | New York |
| Behavioral Health & Social Service Providers / School | 1041S0200X | ||
| Behavioral Health & Social Service Providers / Marriage & Family Therapist | 106H00000X |
Profile Details
| NPI number | 1760537062 |
|---|---|
| LBN Legal business name | Wagner, Carol Theresa |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 24th, 2007 |
| Last updated | Aug 6th, 2010 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1760537062 | NPPES |
| Other | 147324 | VALUE OPTIONS |
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