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

Individual provider Clinical Social Worker · NPI 1760172688

Kenyada Marie Wagoner, LCSW is a Clinical Social Worker in Riverside, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2023
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

3939 13th St
Riverside, CA 92501-3505
Phone: (951) 214-5071
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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 114731 (CA)

Record details

NPI number1760172688
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedMay 12, 2023
Last updated in NPPESMay 12, 2023
Certification dateMay 12, 2023

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