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

Individual provider Clinical Social Worker · NPI 1982093522

Jeremy Michael Wagoner, LCSW is a Clinical Social Worker in Bowling Green, Kentucky. Practices as a sole proprietor. Licensed in Kentucky.

Licensed in
KY
In the registry since
2015
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

1300 Andrea St Ste 205
Bowling Green, KY 42104-3382
Phone: (270) 904-2260
Fax: (270) 781-9680
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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 3958 (KY)

Record details

NPI number1982093522
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorYes
NPI enumeratedJanuary 20, 2015
Last updated in NPPESJanuary 20, 2015

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