Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Ivy Christine Wagner, DBH, LCSW

Individual provider Clinical Social Worker · NPI 1346754702

Dr. Ivy Christine Wagner, DBH, LCSW is a Clinical Social Worker in Bandon, Oregon. Licensed in Oregon. Registered with an NPI since 2017.

Licensed in
OR
In the registry since
2017
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

780 2nd St SE Ste 10
Bandon, OR 97411-8354
Phone: (541) 329-2144
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence L11519 (OR)

Record details

NPI number1346754702
Entity typeIndividual (Type 1)
GenderFemale
Credentials DBH , LCSW
Sole proprietorNo
NPI enumeratedNovember 21, 2017
Last updated in NPPESAugust 16, 2024
Certification dateAugust 16, 2024

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