NPI 1265537484 · live from the CMS NPI Registry
Ian Jeffrey Agar, MSW, LCSW, CADC III
Social Worker, Clinical in Wausau, WI. National Provider Identifier 1265537484, active.
NPI record
| NPI | 1265537484 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Social Worker, Clinical 1041C0700X |
| Practice location | Wausau Veterans Outpatient Clinic, 515 S. 32nd Avenue, Wausau, WI 54401 |
| Practice phone | 715-842-2834 |
| Mailing address | W15354 County Highway D, Witttenberg, WI 54499 |
| Enumerated | September 13, 2006 |
| Last updated | May 8, 2014 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | 13523 (WI) |
| Social Worker, Clinical primary | 1041C0700X | 7098-123 (WI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.