MS. THERESSA MARIE WAGNER MSW LCSW
NPI 1326196759
Social Worker - Clinical in Centreville, MI

Active since January 08, 2007
677A EAST MAIN, CENTREVILLE, MI 49032(269) 467-1000 Get Directions Write a Review

NPPES record last updated: July 17, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ms. Theressa Marie Wagner Msw Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. THERESSA MARIE WAGNER MSW LCSW (NPI 1326196759) is an individual clinical provider in Centreville, Michigan, licensed in Michigan (6801078479) and active in the NPI registry since January 2007.

NPPES Registry Identity

NPI1326196759
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMS. THERESSA MARIE WAGNERCredential: MSW LCSW
Location Address677A EAST MAINCentreville, MI 49032
Mailing Address677a East MainCentreville, MI 49032 · (269) 467-1000 · Fax (269) 467-3075
Sole ProprietorNo
Enumeration DateJanuary 8, 2007
Last NPPES UpdateJuly 17, 2009
NPI 1326196759 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License Licensed in MI · 6801078479
Definition
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.
677A EAST MAIN, Centreville, MI 49032

Other Names 1

Former Name (1)Theressa Marie Wagner Kullok

Other Identifiers 2

Medicaid1708146MI
Medicare ID-Type Unspecified0G56011MI

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychologist
677A EAST MAIN
CENTREVILLE, MI 49032
Counselor (Mental Health)
677A EAST MAIN
CENTREVILLE, MI 49032
Social Worker (Clinical)
677A EAST MAIN
CENTREVILLE, MI 49032
Social Worker (Clinical)
677A EAST MAIN
CENTREVILLE, MI 49032
Counselor (Professional)
677A EAST MAIN
CENTREVILLE, MI 49032
Registered Nurse
677A EAST MAIN
CENTREVILLE, MI 49032
Licensed Practical Nurse
677A EAST MAIN
CENTREVILLE, MI 49032
Social Worker (Clinical)
677A EAST MAIN
CENTREVILLE, MI 49032

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Theressa Wagner's NPI number?

The NPI number for Theressa Wagner is 1326196759. It was assigned to this individual provider in the NPPES registry on January 8, 2007. The provider is also known as Theressa Marie Wagner Kullok.

Where is Theressa Wagner located?

Theressa Wagner practices at 677A East Main, Centreville, MI 49032. The listed phone number is (269) 467-1000.

What is Theressa Wagner's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Theressa Wagner was last updated on July 17, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.