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
Phone: (402) 494-5265
Fax:
Website:
Health care specialties
Specialty | Code | License # | 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1841464799 | NPPES |
Nebraska | MEDICAID | 2311 |
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