Individual
JO-ANN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1318 JAMESTOWN RD, SUITE 101, WILLIAMSBURG, VA 23185-3382
(757) 229-7927
(757) 253-8891
Mailing address
1318 JAMESTOWN RD, SUITE 101, WILLIAMSBURG, VA 23185-3382
(757) 229-7927
(757) 253-8891
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904000859
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000249
VALUE OPTIONS
VA
01
—
086720
OPTIMA
VA
01
—
13467
CIGNA
VA
01
—
323507
MHN
VA
01
—
339165
MAMSI/ALLIANCE
VA
01
—
380403
ANTHEM
VA
05
—
8903913
—
VA
Enumeration date
09/17/2006
Last updated
07/09/2007
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