Active NPIIndividual providerSole proprietor

Ms. Susan Bandler Wagner, LICSW

Social Worker, Clinical in Newfane, Vermont

NPI Number1700901568
Practice location
23 West Street, Newfane, VT 05345
Fax
—
Last updated
July 31, 2014

Susan Bandler Wagner is a Social Worker, Clinical based in Newfane, VT. Susan Bandler Wagner practices in Newfane, VT and has the professional credentials of LICSW. The NPI Number for Susan Bandler Wagner is 1700901568 and holds a License No. 089-0000330 (VT). The current practice location address for Susan Bandler Wagner is 23 West Street, Newfane, VT 05345 and can be reached out via phone at 802-365-9115.

Provider Profile Details

NPI Number
1700901568
Provider Name
Susan Bandler Wagner
Credential
LICSW
Provider Entity Type
Individual
Gender
Female
Address
23 West Street, Newfane, VT 05345
Phone Number
802-365-9115
Primary Taxonomy
Social Worker, Clinical · 1041C0700X
Sole Proprietor
Yes
Other Names
Susan Bandler Wagner, LICSW (Professional Name)
Provider Enumeration Date
March 20, 2007
Last Update Date
July 31, 2014
NPI Status
Active

Provider Business Practice Location Address Details

Address
23 West Street
Newfane, VT 05345
State
Vermont
Zip
05345
Phone Number
802-365-9115
Newfane, VT 05345Get directions →

Provider Business Mailing Address Details

Address
Po Box 344
Newfane, VT 05345-0344
City
Newfane
State
VT
Zip
05345-0344
Phone Number
802-365-9115

License Information

License Number
089-0000330
License State
VT
Taxonomy
Social Worker, Clinical · 1041C0700X · Primary

Legacy Identifiers

IdentifierTypeStateIssuer
No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.

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Frequently Asked Questions

What is the NPI number of Ms. Susan Bandler Wagner, LICSW?

The NPI number of Ms. Susan Bandler Wagner, LICSW is 1700901568. It was assigned on March 20, 2007 and is currently active in the NPPES registry.

What is the specialty of Ms. Susan Bandler Wagner, LICSW?

Ms. Susan Bandler Wagner, LICSW is registered under the primary taxonomy Social Worker, Clinical (code 1041C0700X), licensed in VT under license number 089-0000330.

Where does Ms. Susan Bandler Wagner, LICSW practice?

The practice location is 23 West Street, Newfane, VT 05345. The office can be reached at 802-365-9115 (phone).

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.

How do I verify this NPI record?

This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1700901568 directly on the NPPES registry website.

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