MARILYN M. WAGNER PH.D., PSC (NPI# 1265689475) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265689475 |
| Entity Type | Organization |
| Organization Name | MARILYN M. WAGNER PH.D., PSC |
| Practice Address |
105a Crescent Ave Louisville KY 40206-1525 |
| Practice Telephone | 5028934011 |
| Mailing Telephone | 5028934011 |
| Enumeration Date | 2008-08-20 |
| Last Update Date | 2008-08-20 |
| Authorized Official Name | DR. MARILYN M WAGNER (PRESIDENT) |
| Authorized Official Telephone | 5028934011 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 0553 | KY | Behavioral Health & Social Service Providers |
| Street Address |
105A CRESCENT AVE |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40206-1525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285243477 | Stephanie Atherton | Nurse Practitioner | 1623 Story Ave, Louisville, KY 40206 | 2020-07-24 |
| 1023547460 | Jeffrey Obiora | Student in an Organized Health Care Education/Training Program | 500 South Preston St, Room 305, Lousiville, KY 40206 | 2017-06-08 |
| 1053840710 | Mary Oliver Humke | Lactation Consultant, Non-RN | 155 N Galt Ave, Louisville, KY 40206 | 2017-06-07 |
| 1417304908 | James Edward Meffert Sr. | Dentist | 1618 Story Ave. (home/office Setting), Louisville, KY 40206 | 2016-05-16 |
| 1235516527 | Jara Nashelle Vega Velez | Internal Medicine | 800 Zorn Ave Dept Of, Louisville, KY 40206 | 2015-05-06 |
| 1184058885 | Reba D Ziller | Occupational Therapist | 4604 Lowe Road, Regis Woods Rehab Center, Louisville, KY 40206 | 2013-08-29 |
| 1407109176 | Jessica L Hoback | Physical Therapy Assistant | 2141 Sycamore Avenue, Louisville, KY 40206 | 2012-10-18 |
| 1598039315 | Mary Barbara Sowers | Emergency Medicine | 611 Emery Rd, Louisville, KY 40206 | 2012-02-24 |
| 1053628479 | Adrian J Pellegrini Md | Nurse Practitioner | 170 Crescent Ave, Louisville, KY 40206 | 2010-09-07 |
| 1518297761 | Kiley Nontell Mcneill | Behavioral Analyst | 1100 East Market St., Louisville, KY 40206 | 2010-01-12 |
| Find all providers in zip 40206 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437393170 | Bradley Scott Folley | Clinical Neuropsychologist | 4950 Norton Healthcare Blvd Ste 205, Louisville, KY 40241-2847 | 2009-04-24 |
| 1073704011 | Jennifer A Geiger | Clinical Neuropsychologist | 275 Century Cir Ste 203, Louisville, CO 80027-9453 | 2007-08-06 |
| 1619186467 | James Frederick Phifer | Clinical Neuropsychologist | 440 Breckenridge Lane Ste 124, Louisville, KY 40218 | 2007-05-21 |
| 1508916958 | Michael H Cecil | Clinical Neuropsychologist | 13293 Obannon Station Way, Louisville, KY 40223-4188 | 2007-01-10 |
| 1396763249 | Jacquelyn J. Graven | Clinical Neuropsychologist | 421 Benjamin Lane, Ste 202, Louisville, KY 40222 | 2006-07-18 |
| 1154301356 | Donald Bradley Burton | Clinical Neuropsychologist | 4200 Browns Ln, Louisville, KY 40220-1523 | 2006-01-23 |
| 1356333090 | Melissa A Boyles | Clinical Neuropsychologist | 2915 Frankfort Ave, Suite E, Louisville, KY 40206-2682 | 2005-08-18 |
| 1518968205 | Richard I Edelson | Clinical Neuropsychologist | 7511 New Lagrange Rd, Louisville, KY 40222-4859 | 2005-08-03 |
| 1164429320 | Jeanne Marie Bennett | Clinical Neuropsychologist | 1169 Eastern Pkwy Ste 2238, Louisville, KY 40217-1444 | 2005-07-02 |
| 1174520530 | Dennis Buchholz | Clinical Neuropsychologist | 1161 E Broadway, Louisville, KY 40204-1711 | 2005-06-30 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40206 |
Please comment or provide details below to improve the information on MARILYN M. WAGNER PH.D., PSC.
| 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.