Jennifer Wagner, LCSW
Social Worker, Clinical in Sarasota, FL. Individual provider (NPI-1).
NPI number1982829446
StatusActive
Last updated in NPPESJun 14, 2025
Details
- NPI
- 1982829446
- Entity type
- Individual (NPI-1)
- Name
- Jennifer Wagner
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 17, 2007
- Certification date
- Jun 14, 2025
- Last updated
- Jun 14, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | SW11720 | FL | Yes |
Practice location
1705 Shoreland DrSarasota, FL 34239-5034
Phone 617-721-5395
Mailing address
1705 Shoreland DrSarasota, FL 34239-5034
Phone 617-232-2138
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