Wagner, Alicia Ann
Wagner, Alicia Ann is an individual health care provider with primary practice located at 1909 Vicki Ln Ste 105 , Norfolk NE 68701-4542. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Wagner, Alicia Ann can be contacted via phone (402) 256-7883.Contact Information
Primary practice address
1909 Vicki Ln Ste 105
Norfolk NE 68701-4542
Phone: (402) 256-7883
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 4490 | Nebraska |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 1556 | Nebraska |
Profile Details
| NPI number | 1649782574 |
|---|---|
| LBN Legal business name | Wagner, Alicia Ann |
| Credentials | LIMHP, LCSW, LADC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 1st, 2017 |
| Last updated | Dec 23rd, 2023 - about last year |
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 | 1649782574 | NPPES |
| Nebraska | MEDICAID | 10028558800 |
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