DR. KARL FREDERIC WAGNER (NPI# 1154584217) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154584217 |
| Entity Type | Individual |
| Full Name | DR. KARL FREDERIC WAGNER |
| Credential | PSY.D. |
| Practice Address |
875 Massachusetts Ave Suite 84 Cambridge MA 02139-3067 |
| Practice Telephone | 6174941650 |
| Practice Fax Number | 6174941975 |
| Mailing Telephone | 6174941650 |
| Mailing Fax Number | 6174941975 |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2008-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
7443 | MA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538193131 | Karl Steven Wagner | Obstetrics & Gynecology | 332 W Tienken Rd, Suite B, Rochester Hills, MI 48306-4473 | 2006-07-10 |
| 1720179500 | Karl Gordon Wagner Jr. | Physician Assistant | 22255 Greenfield Rd, Suite 422, Southfield, MI 48075-3710 | 2006-09-27 |
| 1427099183 | Karl G Wagner | Anesthesiology | 2500 Metrohealth Dr, Department of Anesthesiology, Cleveland, OH 44109-1900 | 2006-06-10 |
| 1093716573 | Karl Thomas Wagner Jr. | Orthopaedic Surgery | 1824 Dorchester Ct, Suite A, Goshen, IN 46526-6819 | 2005-08-09 |
| Street Address |
875 MASSACHUSETTS AVE SUITE 84 |
| City | CAMBRIDGE |
| State | MA |
| Zip Code | 02139-3067 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679564108 | Sanda Soe Aung | Psychiatry & Neurology | 875 Massachusetts Ave, 75, Cambridge, MA 02139-3067 | 2005-11-03 |
| 1114533312 | Stacey Slate Pllc | Counselor | 875 Massachusetts Ave, Cambridge, MA 02139-3067 | 2020-09-22 |
| 1568831493 | Russell L Forman, Dmd, PC | Clinic/Center | 875 Massachusetts Ave, Suite 63, Cambridge, MA 02139-3067 | 2015-09-22 |
| 1871900100 | Khristy Fontillas | Dentist | 875 Massachusetts Ave, Suite 63, Cambridge, MA 02139-3067 | 2014-07-18 |
| 1073948154 | Silvia Dominguez | Counselor | 875 Massachusetts Ave, Cambridge, MA 02139-3067 | 2013-09-09 |
| 1316387020 | Azimuth Psychological | Psychologist | 875 Massachusetts Ave, #21, Cambridge, MA 02139-3067 | 2013-06-26 |
| 1417392929 | Valerie Blanc | Counselor | 875 Massachusetts Ave, Suite 2-5, Cambridge, MA 02139-3067 | 2013-05-10 |
| 1508109083 | Shannon Kelly | Social Worker | 875 Massachusetts Ave, #61, Cambridge, MA 02139-3067 | 2013-04-03 |
| 1033453584 | Highland Psychological Associates, LLC | Psychologist | 875 Massachusetts Ave, Suite 71, Cambridge, MA 02139-3067 | 2012-11-23 |
| 1356698450 | Amy Lauren Mitchell | Psychologist | 875 Massachusetts Ave, Suite 61, Cambridge, MA 02139-3067 | 2012-08-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598316044 | Diane Greenleaf | Registered Nurse | Cha Windsor Clinic, 119 Windsor St, Cambridge, MA 02139 | 2019-09-26 |
| 1730738345 | Martin Bednar | Student in an Organized Health Care Education/Training Program | 350 Massachusetts Avenue, Cambridge, MA 02139 | 2019-09-06 |
| 1861050049 | Rebecca Marie Addison | Dietitian, Registered | 75 Auburn St, Cambridge, MA 02139 | 2019-06-03 |
| 1285103051 | Jenna Halloran | Social Worker | 929 Massaschusetts Ave, Cambridge, MA 02139 | 2018-11-21 |
| 1750859286 | Lisa Marie Keovongsa | Dietitian, Registered | 186 1/2 Hampshire St., Cambridge, MA 02139 | 2018-11-02 |
| 1245714237 | Eleanor Coffin | Occupational Therapist | 1483 Cambridge St, Cambridge, MA 02139 | 2018-09-17 |
| 1649758277 | Sariya Idriss | Social Worker | Cambridge Health Alliance, 1493 Cambridge St., Cambridge, MA 02139 | 2018-08-06 |
| 1538647151 | Ari Pehkonen | Social Worker | Cambridge Health Alliance, Cambridge Hospital, 1493 Cambridge St., Cambridge, MA 02139 | 2018-08-06 |
| 1972080893 | Esther Cazeau | Counselor | 237 Hampshire St., Cambridge, MA 02139 | 2018-07-24 |
| 1528596533 | Adam Liebling | Acupuncturist | 11 Fiske Pl., Cambridge, MA 02139 | 2017-06-03 |
| Find all providers in zip 02139 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114537131 | Annemarie Baldauf, Psyd, Pllc | Psychologist | 49 Hancock St Ste 104, Cambridge, MA 02139-3188 | 2020-08-04 |
| 1881216588 | Massomeh Namavar | Psychologist | 221 Mount Auburn St Apt 104, Cambridge, MA 02138-4848 | 2020-05-15 |
| 1396367736 | Laura Genelle Meza Valencia | Psychologist | One Mifflin Place, Suite 400, Cambridge, MA 02138-4946 | 2020-05-07 |
| 1033672100 | Dr Kerrie LLC | Psychologist | 10 Hawthorne Park, Cambridge, MA 02138-2104 | 2019-04-07 |
| 1912481227 | Mary E. Ford | Psychologist | 195 Harvey St, Cambridge, MA 02140-1765 | 2018-09-21 |
| 1871089227 | Ellsworth Fersch | Psychologist | 70 Richdale Ave Apt 2, Cambridge, MA 02140-2640 | 2018-07-09 |
| 1134610751 | Jill Hooley | Psychologist | 33 Kirkland St, Cambridge, MA 02138-2044 | 2018-05-21 |
| 1053836080 | Kim Michael Woynowskie Jr. | Psychologist | 625 Mount Auburn St Ste 102, Cambridge, MA 02138-4555 | 2017-08-10 |
| 1306383351 | Elise I Welton | Psychologist | 22 Water St, Apt. 411, Cambridge, MA 02141-1257 | 2017-01-30 |
| 1174984827 | Jenna Mezin Schmid | Psychologist | 75 Mt Auburn St 4 East, Harvard University Health Services, Cambridge, MA 02138 | 2016-03-09 |
| Find all providers in CAMBRIDGE | ||||
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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.