National Provider Identifier
Brooke Leigh Wagner, LCSW
Brooke Leigh Wagner, LCSW is listed in the NPPES registry with a primary specialty of Clinical Social Worker in Victor, NY and a listed phone number of (585) 398-8835.
Profile Overview
- NPI
- 1265154454
- Provider Type
- Individual
- Primary Specialty
- Clinical Social Worker
- Enumeration Date
- September 14, 2022
- Last Updated
- September 14, 2022
Practice Location
- 6539 Anthony Dr Ste A
- Victor, NY 14564-1441
Phone: (585) 398-8835
Mailing Address
- 2012 Rainbow Ln
- Lima, NY 14485-9453
Specialties
- Clinical Social Worker (1041C0700X)
Full Record
- NPI
- 1265154454
- Entity Type
- Individual
- Last Name
- Wagner
- First Name
- Brooke
- Middle Name
- Leigh
- Credential
- LCSW
- Mailing Street Address
- 2012 Rainbow Ln
- Mailing City
- Lima
- Mailing State
- NY
- Mailing ZIP Code
- 14485-9453
- Mailing Country
- US
- Practice Street Address
- 6539 Anthony Dr Ste A
- Practice City
- Victor
- Practice State
- NY
- Practice ZIP Code
- 14564-1441
- Practice Country
- US
- Practice Phone
- (585) 398-8835
- Enumeration Date
- September 14, 2022
- Last Updated
- September 14, 2022
- Sex
- Female
- Sole Proprietor
- Yes
- Certification Date
- September 12, 2022
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Clinical Social Worker (1041C0700X)