Wagner, James L

Wagner, James L is an individual health care provider with primary practice located at 402 W 19Th St , South Sioux City NE 68776-2639. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Wagner, James L can be contacted via phone (402) 494-5265.

Contact Information

Primary practice address
402 W 19Th St South Sioux City NE 68776-2639
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 2311 Nebraska

Profile Details

NPI number 1841464799
LBN Legal business name Wagner, James L
Credentials LMHP
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 22nd, 2008
Last updated Jan 12th, 2010 - about 15 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 1841464799 NPPES
Nebraska MEDICAID 2311

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