Wagner, Darrah A

Wagner, Darrah A is an individual health care provider with primary practice located at 29 Franklin St , Bangor ME 04401-4909. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Psychiatric/Mental Health, Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Social Worker is her primary health care specialty. Wagner, Darrah A can be contacted via phone (207) 942-3816.

Contact Information

Primary practice address
29 Franklin St Bangor ME 04401-4909
Phone: (207) 942-3816
Fax: (207) 561-4725
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Psychiatric/Mental Health 163WP0808X R026710 Maine
Behavioral Health & Social Service Providers / Social Worker 104100000X LC8702 Maine

Profile Details

NPI number 1427099688
LBN Legal business name Wagner, Darrah A
Credentials LCSW,RN
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2006
Last updated May 4th, 2011 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427099688 NPPES
Maine Other 098304 ANTHEM LEGACY - LCSW
Maine MEDICAID 431984999 ANTHEM LEGACY - LCSW

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