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Keith Harold Wagoner, COUNSELOR
Addiction (Substance Use Disorder) Counselor in Sacramento, California
NPI 1114268588

Keith Harold Wagoner is an Addiction (Substance Use Disorder) Counselor based in Sacramento, CA and is specialized in Addiction (Substance Use Disorder). Keith Harold Wagoner practices in Sacramento, CA and has the professional credentials of COUNSELOR. The NPI Number for Keith Harold Wagoner is 1114268588 and holds a License No. A022760416 (California).

The current practice location address for Keith Harold Wagoner is 2150 Stockton Blvd, Sacramento, CA and can be reached out via phone at 916-875-1000.

Location: 2150 Stockton Blvd, Sacramento, CA, 95817-1337
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1114268588
Provider Name
Keith Harold Wagoner
Credential
COUNSELOR
Provider Entity Type
Individual
Gender
Male
Address
2150 Stockton Blvd, Sacramento, CA, 95817-1337
Phone Number
916-875-1000
Fax Number
Provider Enumeration Date
03/11/2013
Last Update Date
09/14/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
101Y00000X 05 CA
institution
Provider Business Practice Location Address Details
Address
2150 Stockton Blvd
City
Sacramento
State
California
Zip
95817-1337
Phone Number
916-875-1000
Fax Number
person
Provider Business Mailing Address Details
Address
2150 Stockton Blvd
City
Sacramento
State
California
Zip
95817-1337
Phone Number
916-875-1000
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
()
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Other Service Providers
Classification
Case Manager/Care Coordinator
Speciality
-
Taxonomy
171M00000X
License No.
A022760416 (California)
Definition
A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.
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