Kelly Marie Wagner, LCSW in Erie, PA - Medicare Social Worker Provider

Kelly Marie Wagner, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Erie, Pennsylvania. Her current practice location is 1932 Brooksboro Dr, Erie, Pennsylvania. You can reach out to her office (for appointments etc.) via phone at (814) 708-2010.

Kelly Marie Wagner is licensed to practice in North Carolina (license number C018909) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1992464465.

Contact Information

	Kelly Marie Wagner, LCSW
	1932 Brooksboro Dr, Erie, PA 16510-3872
	(814) 708-2010
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Kelly Marie Wagner
Gender	Female
Speciality	Social Worker - Clinical
Location	1932 Brooksboro Dr, Erie, Pennsylvania
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1992464465
Provider Enumeration Date: 12/13/2021
Last Update Date: 12/02/2025

Medicare PECOS Information:

PECOS PAC ID: 9335517317
Enrollment ID: I20221122003474

Medical Identifiers

Medical identifiers for Kelly Marie Wagner such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1992464465	NPI	-	NPPES
C018909	Other	NC	LICENSE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	C018909 (North Carolina)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kelly Marie Wagner allows following entities to bill medicare on her behalf.

Entity Name	Western North Carolina Community Health Services Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1780801050 PECOS PAC ID: 0840264669 Enrollment ID: O20040825001424

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kelly Marie Wagner is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Kelly Marie Wagner, LCSW 1932 Brooksboro Dr, Erie, PA 16510-3872 Ph: (814) 490-0015	Kelly Marie Wagner, LCSW 1932 Brooksboro Dr, Erie, PA 16510-3872 Ph: (814) 708-2010

Reviews and Comments

Social Worker in Erie, PA

Emily Perkins, LSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 135 E 38th St, Erie, PA 16504 Phone: 814-860-2471
Kristen A Schenker, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1373 W 6th St, Erie, PA 16505 Phone: 814-873-4205
Brent Vargo, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 2910 State St, Erie, PA 16508 Phone: 814-464-5686
Donna M Snyder, LCSW, CAC DIPLOMATE Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1910 Sassafras St, Suite 100, Erie, PA 16502 Phone: 814-452-5490 Fax: 814-452-7610
Ms. Antoinette Louise Baker-mulford, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 5100 Peach St, Erie, PA 16509 Phone: 814-866-4500 Fax: 814-866-2677
Karly Bender, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 2220 W 8th St Ste 1, Erie, PA 16505 Phone: 814-546-3155
Mrs. Julia Rose Copen, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1910 Sassafras St, Erie, PA 16502 Phone: 814-452-5843 Fax: 814-452-7610

Kelly Marie Wagner, LCSW - Medicare Clinical Social Worker in Erie, PA