# ALISSA WAGNER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1417489196
- **Gender:** F
- **Credential:** LCSW

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 07845-S | NV | — |
| 1041C0700X | Clinical Social Worker | 13032-C | NV | Yes |
| 1041C0700X | Clinical Social Worker | IC-2382 | NV | Yes |

## Other

- **Enumeration date:** 03/31/2017
- **Last updated:** 09/11/2026