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  7. NPI Record 1336694637

MARY KATHERINE WANNER LCSW
Complete NPI Record 1336694637
Social Worker - Clinical in Albany, GA

NPI Status: Active since August 17, 2016

Contact Information

2500 DAWSON RD STE 101
ALBANY, GA
ZIP 31707
Phone: (229) 430-5100

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider Middle Name
  6. Provider Credential Text
  7. Provider First Line Business Mailing Address
  8. Provider Business Mailing Address City Name
  9. Provider Business Mailing Address State Name
  10. Provider Business Mailing Address Postal Code
  11. Provider Business Mailing Address Country Code If outside U S
  12. Provider First Line Business Practice Location Address
  13. Provider Business Practice Location Address City Name
  14. Provider Business Practice Location Address State Name
  15. Provider Business Practice Location Address Postal Code
  16. Provider Business Practice Location Address Country Code If outside U S
  17. Provider Business Practice Location Address Telephone Number
  18. Provider Enumeration Date
  19. Last Update Date
  20. Provider Gender Code
  21. Healthcare Provider Taxonomy Code 1
  22. Provider License Number 1
  23. Provider License Number State Code 1
  24. Healthcare Provider Primary Taxonomy Switch 1
  25. Is Sole Proprietor

Complete NPI Dataset

This page represents the complete record for NPI 1336694637. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1336694637
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Entity Type Code: 1
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider First Name: MARY
The city name in the location address of the provider being identified.
Provider Middle Name: KATHERINE
The State code in the location of the provider being identified.
Provider Credential Text: LCSW
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider First Line Business Mailing Address: PO BOX 1988
The country code in the location address of the provider being identified.
Provider Business Mailing Address City Name: ALBANY
The telephone number associated with the location address of the provider being identified.
Provider Business Mailing Address State Name: GA
The fax number associated with the location address of the provider being identified.
Provider Business Mailing Address Postal Code: 317021988
The date the provider was assigned a unique identifier (assigned an NPI).
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider First Line Business Practice Location Address: 2500 DAWSON RD STE 101
The code designating the provider’s gender if the provider is a person.
Provider Business Practice Location Address City Name: ALBANY
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider Business Practice Location Address State Name: GA
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider Business Practice Location Address Postal Code: 317071326
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Provider Business Practice Location Address Country Code If outside U S : US
Provider Business Practice Location Address Telephone Number: 2294305100
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No
Provider Enumeration Date: 8/17/2016
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 8/17/2016
The date that a record was last updated or changed.
Provider Gender Code: F
The code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 1041C0700X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: CSW003991
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1: GA
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: Y
Is Sole Proprietor: N
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No