JEREMY MICHAEL WAGONER (NPI# 1982093522) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982093522 |
| Entity Type | Individual |
| Full Name | JEREMY MICHAEL WAGONER |
| Credential | LCSW |
| Practice Address |
1300 Andrea St Suite 205 Bowling Green KY 42104-3382 |
| Practice Telephone | 2709042260 |
| Practice Fax Number | 2707819680 |
| Mailing Telephone | 2709042260 |
| Mailing Fax Number | 2707819680 |
| Enumeration Date | 2015-01-20 |
| Last Update Date | 2015-01-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
3958 | KY | Behavioral Health & Social Service Providers |
| Street Address |
1300 ANDREA ST SUITE 205 |
| City | BOWLING GREEN |
| State | KY |
| Zip Code | 42104-3382 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427146950 | Cindy S Lemon | Nurse Practitioner | 1300 Andrea St, Suite 205, Bowling Green, KY 42104-3382 | 2006-10-10 |
| 1104358597 | Kentucky Psychiatry, LLC | Nurse Practitioner | 1300 Andrea St, Suite 205, Bowling Green, KY 42104-3382 | 2017-04-03 |
| 1003364373 | Verdant Healthcare LLC | Clinic/Center | 1300 Andrea St, Suite 100, Bowling Green, KY 42104-3382 | 2016-09-15 |
| 1881060754 | Phillip G. Walker | Nurse Practitioner | 1300 Andrea St, Suite 205, Bowling Green, KY 42104-3382 | 2015-08-14 |
| 1346638723 | Hillary Blair Stansfield | Social Worker | 1300 Andrea St, Suite 205, Bowling Green, KY 42104-3382 | 2015-01-07 |
| 1679992978 | Allison Coghill | Nurse Practitioner | 1300 Andrea St, Suite 205, Bowling Green, KY 42104-3382 | 2014-04-15 |
| 1528327038 | Sandra T Mahoney | Social Worker | 1300 Andrea St, Suite 205, Bowling Green, KY 42104-3382 | 2012-05-04 |
| 1518235183 | Dbt Center of Western Kentucky, LLC | Social Worker | 1300 Andrea St, Suite 205, Bowling Green, KY 42104-3382 | 2011-12-09 |
| 1497049977 | Heather Hazelwood Dausman | Social Worker | 1300 Andrea St, Suite 205, Bowling Green, KY 42104-3382 | 2011-06-02 |
| 1770797623 | Community Options, Inc. | Case Management | 1300 Andrea St, Suite 201, Bowling Green, KY 42104-3382 | 2007-05-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043822042 | Ashley Marie Sterchi | Speech-Language Pathologist | The Kid Spot Center, 944 Fields Dr. #102, Bowling Green, KY 42104 | 2020-08-20 |
| 1093339111 | Rachel Marie Held | Specialist/Technologist | 886c Lynnwood Way, Apt. #7, Bowling Green, KY 42104 | 2020-06-04 |
| 1043846769 | C D S 10 Pharmacy LLC | Pharmacy | 1308 Ashley Circle, Bowling Green, KY 42104 | 2020-03-13 |
| 1073075792 | Applegate Health Services, Inc | Clinic/Center | 5966 Scottsville Road Unit 7, Bowling Green, KY 42104 | 2019-04-02 |
| 1487122099 | Candice Spencer | Specialist/Technologist, Other | 1945 Scottsville Rd B2 Pmb 397, Bowling Green, KY 42104 | 2018-11-13 |
| 1053819904 | Cumberland Foot and Ankle Centers | Orthopaedic Surgery | 1850 Westen Street, Bowling Green, KY 42104 | 2018-01-25 |
| 1841731494 | Olivia Catherine Sanders | Speech-Language Pathologist | 954 Aristides Dr, Bowling Green, KY 42104 | 2017-03-15 |
| 1376901488 | Trung Trinh | Pharmacist | 1530 Campbell Lane, Bowling Green, KY 42104 | 2016-02-03 |
| 1225409121 | Adam Wesley Baird | Optometrist | 760 Campbell Lane, Suite 120, Bowling Green, KY 42104 | 2015-10-18 |
| 1851797898 | Michelle Leigh King | Speech-Language Pathologist | 829 Mandarin Ave., Bowling Green, KY 42104 | 2014-11-18 |
| Find all providers in zip 42104 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114544368 | Ariel Laverne Lee | Social Worker | 730 Fairview Ave Ste B1, Bowling Green, KY 42101-2365 | 2020-07-02 |
| 1548806441 | Hillary S Bacon | Social Worker | 1711 Ashley Cir Ste 6, Bowling Green, KY 42104-5801 | 2019-11-26 |
| 1306491576 | Jessica Mahaney | Social Worker | 1830 Destiny Ln Ste 112, Bowling Green, KY 42104-1089 | 2019-08-05 |
| 1619430444 | Dava R Wilson | Social Worker | 1143 Fairway St Ste 320, Bowling Green, KY 42103-2452 | 2019-04-09 |
| 1689180820 | Teri Drake | Social Worker | 1234 Ridgewood Dr, Bowling Green, OH 43402-2696 | 2017-12-26 |
| 1538698444 | Trevor Bowen Mead | Social Worker | 1306 Richland Way, Bowling Green, KY 42103-1540 | 2017-06-06 |
| 1689102204 | Johnson Counseling LLC | Social Worker | 996 Wilkinson Trce Ste A9, Bowling Green, KY 42103-3408 | 2017-05-25 |
| 1346696143 | Carolyn Kates-glass, Msw, Lcsw | Social Worker | 1338 Westen St, Bowling Green, KY 42104-3365 | 2016-05-11 |
| 1952765612 | Julie Mccoy | Social Worker | 855 Lovers Ln Ste 107, Bowling Green, KY 42103-7989 | 2016-04-08 |
| 1871967406 | Sarah L Whitledge | Social Worker | 1111 Shive Ln Ste 104, Bowling Green, KY 42103-8051 | 2015-11-19 |
| Find all providers in BOWLING GREEN | ||||
| City | BOWLING GREEN |
| Zip Code | 42104 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.