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

Kendra Lynn Wagener, LICSW

Individual provider Clinical Social Worker · NPI 1487505392

Kendra Lynn Wagener, LICSW is a Clinical Social Worker in Saint Paul, Minnesota. Qualified in 2015, 11 years ago. Licensed in Minnesota.

Years since qualifying
11
Licensed in
MN
In the registry since
2026
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

640 Jackson St
Saint Paul, MN 55101-2595
Phone: (651) 254-1000
Fax: (651) 254-9595
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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 27978 (MN)

Record details

NPI number1487505392
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorNo
NPI enumeratedFebruary 5, 2026
Last updated in NPPESApril 17, 2026
Certification dateApril 17, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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