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NPI Code Detail

MEDICARE: HEATHER WAGGENER LCSW

MEDICARE: HEATHER WAGGENER LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator
2101YM0800XMental Health Counselor6356TN

General Provider Information

NPI Number : 1043437577
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER WAGGENER LCSW
Provider Business Mailing Address
First Line : 130 SEABOARD LN STE A10
Second Line :
City : FRANKLIN
State : TN
Zip : 37067-8221
Country : US
Telephone Number : 615-326-9918
Fax Number : 779-201-6241
Provider Business Practice Location Address
First Line : 130 SEABOARD LN STE A10
Second Line :
City : FRANKLIN
State : TN
Zip : 37067-8221
Country : US
Telephone Number : 615-326-9918
Fax Number : 779-201-6241
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2007
Last Update Date : 07/21/2022

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Directions to “ HEATHER WAGGENER LCSW” Practice Location

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