National Provider Identifier Database

THERESSA M WAGNER, MSW LCSW – NPI #1326196759
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.


Contact Information

THERESSA M WAGNER, MSW LCSW
677A EAST MAIN
CENTREVILLE, MI49032
Phone: 269-467-1000
Fax:
Website:
Specialty Taxonomy Code
* Clinical 1041C0700X

* Indicates primary specialty

NPI Profile & details for THERESSA M WAGNER

NPI Number 1326196759
Credentials MSW LCSW
Entity Individual
Enumeration date 01/08/2007
Last updated 07/17/2009 - About 17 years ago
Sole proprietor1 No
Identifiers
  • MI License #: 6801078479
  • MI Medicaid: 1708146
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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