Provider Demographics
NPI:1154355170
Name:WAGNER-KNIGHT, JOYCE LYNN (LSCSW)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:LYNN
Last Name:WAGNER-KNIGHT
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:
Other - Last Name:WAGNER-KNIGHT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LSCSW
Mailing Address - Street 1:5040 SW 28TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66614-2302
Mailing Address - Country:US
Mailing Address - Phone:785-273-6200
Mailing Address - Fax:785-273-6249
Practice Address - Street 1:5040 SW 28TH ST STE B
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-2302
Practice Address - Country:US
Practice Address - Phone:785-273-6200
Practice Address - Fax:785-273-6249
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLSCSW14271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical