JASON ROBERT WAGNER (NPI# 1053700765) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053700765 |
| Entity Type | Individual |
| Full Name | JASON ROBERT WAGNER |
| Credential | ACMHC |
| Practice Address |
8728 S 120 E Sandy UT 84070-1526 |
| Mailing Address |
9880 S Countrywood Dr Sandy UT 84092-3754 |
| Practice Telephone | 8012432928 |
| Mailing Telephone | 8012432928 |
| Enumeration Date | 2015-01-19 |
| Last Update Date | 2015-01-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
7717626-6009 | UT | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821427287 | Jason Leigh Wagner | Counselor | 505 5th St., Suite 520, Sioux City, IA 51101 | 2013-11-06 |
| 1376003517 | Jason Wagner | Student in an Organized Health Care Education/Training Program | 6431 Fannin St # 1.150, Houston, TX 77030-1501 | 2019-03-22 |
| 1720536691 | Jason Fredrick Wagner | Counselor | 6075 Bathey Ln, Naples, FL 34116-7536 | 2016-09-20 |
| 1215329420 | Jason Wagner | Counselor | 2405 28th St, Anacortes, WA 98221-2484 | 2015-02-25 |
| 1457753519 | Jason Wagner | Physician Assistant | 2025 E Route 66, Glendora, CA 91740-4670 | 2014-09-19 |
| 1902168925 | Jason Kane Wagner | Surgery | 600 N Cattlemen Rd Ste 220, Sarasota, FL 34232-6422 | 2012-06-14 |
| 1093014334 | Jason Wagner | Counselor | 360 Whiskey Hill Rd, Watsonville, CA 95076-8521 | 2011-03-25 |
| 1588729768 | Jason E Wagner | Internal Medicine | 3400 Civic Center Blvd, West Pavilion 1st Fl, Philadelphia, PA 19104-5127 | 2006-12-27 |
| 1689641961 | Jason C Wagner | Emergency Medicine | 400 S Kingshighway Blvd, Saint Louis, MO 63110-1014 | 2006-03-05 |
| 1972594471 | Jason Michael Wagner | Radiology | 940 Ne 13th St, Suite 4g4250, Oklahoma City, OK 73104-5008 | 2005-11-03 |
| Street Address |
8728 S 120 E |
| City | SANDY |
| State | UT |
| Zip Code | 84070-1526 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598242893 | Wide Mind Wellness, LLC | Social Worker | 8728 S 120 E, Sandy, UT 84070-1526 | 2018-07-19 |
| 1396235156 | Cottonwood Center for Counseling | Clinic/Center | 8728 S 120 E, Sandy, UT 84070-1526 | 2018-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639777568 | Megan Komatsu Inc. | Social Worker | 10815 700 East, Sandy, UT 84070 | 2020-10-13 |
| 1841803137 | Anywhere Care | Nurse Practitioner | 9980 S. 300 W. Suite 200, Sandy, UT 84070 | 2020-08-26 |
| 1245840552 | Kirandeep Kaur | Psychologist | 9678 700 E # 102, Sandy, UT 84070 | 2020-08-03 |
| 1740890961 | Elizabeth Lowe Madsen | Counselor | 9678 700 East Suite 102, Sandy, UT 84070 | 2020-08-03 |
| 1417597188 | Hayley Burr | Counselor | 8706 700 E, Suite 205, Sandy, UT 84070 | 2020-01-10 |
| 1821656422 | Karen Ritchie | Counselor | 9192 South 300 West, Sandy, UT 84070 | 2019-05-30 |
| 1679068159 | Derek Livingston | Counselor | 11075 State St #35, Sandy, UT 84070 | 2018-06-27 |
| 1891283735 | Alta Rx LLC. | Pharmacy | 9883 South 500 West, Sandy, UT 84070 | 2018-04-26 |
| 1790273704 | The Addiction Medicine Physicians Group, LLC | Registered Nurse | 9160 S 300 E. Ste 25, Sandy, UT 84070 | 2018-04-25 |
| 1841794765 | Caryn Beazel | Physical Therapist | 9350 150 E, Sandy, UT 84070 | 2018-03-23 |
| Find all providers in zip 84070 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740890961 | Elizabeth Lowe Madsen | Counselor | 9678 700 East Suite 102, Sandy, UT 84070 | 2020-08-03 |
| 1508486473 | Integrative Counseling, LLC | Counselor | 510 E Sego Lily Dr, Sandy, UT 84070-3546 | 2020-04-21 |
| 1811526122 | Moving Forward Counseling | Counselor | 9571 S 700 E Ste 101, Sandy, UT 84070-3472 | 2020-04-07 |
| 1417597188 | Hayley Burr | Counselor | 8706 700 E, Suite 205, Sandy, UT 84070 | 2020-01-10 |
| 1205484755 | Live for Life Behavioral Health, LLC | Counselor | 9045 S 1300 E # 200, Sandy, UT 84094-3134 | 2019-08-28 |
| 1821656422 | Karen Ritchie | Counselor | 9192 South 300 West, Sandy, UT 84070 | 2019-05-30 |
| 1912464546 | Russell Edward Peters | Counselor | 10708 S 1300 E Ste 103, Sandy, UT 84094-5027 | 2019-03-01 |
| 1033673926 | David S Bridgeman | Counselor | 781 E Autumn Field Dr, Sandy, UT 84094-1872 | 2019-01-25 |
| 1538640347 | Brandon Stewart Bunker | Counselor | 9055 S 1300 E Ste 107, Sandy, UT 84094-3133 | 2018-08-29 |
| 1679068159 | Derek Livingston | Counselor | 11075 State St #35, Sandy, UT 84070 | 2018-06-27 |
| Find all providers in SANDY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.