MR. ROBERT BRUCE WAGNER (NPI# 1477608107) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477608107 |
| Entity Type | Individual |
| Full Name | MR. ROBERT BRUCE WAGNER |
| Credential | L.P.C. |
| Practice Address |
333 N 2nd St Suite 305 Niles MI 49120-2258 |
| Practice Telephone | 2694498951 |
| Mailing Telephone | 2694498951 |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
6401000453 | MI | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194266734 | Robert Wagner | Contractor | 15 Misery Mountain Ln, Croydon, NH 03773-6617 | 2017-03-15 |
| 1639498553 | Robert Fredrick Wagner Jr. | Dentist | 9616 Beauclerc Bluff Rd, Jacksonville, FL 32257-5703 | 2010-05-18 |
| 1821225160 | Robert Morris Wagner | Obstetrics & Gynecology | 1004 Erie Dr, Buffalo, WY 82834-2587 | 2009-06-13 |
| 1982875852 | Robert Michael Wagner | Psychologist | 160 East Kellogg Blvd., Suite 8500, St. Paul, MN 55101 | 2008-03-18 |
| 1467673111 | Robert Wagner | Counselor | 3837 N.w. 23rd Street, Oklahoma City, OK 73112 | 2007-05-01 |
| 1558499079 | Robert Wagner | Preventive Medicine | 2850 7th St Ste 100, Berkeley, CA 94710-2703 | 2007-02-28 |
| 1679600944 | Robert Linton Wagner | Dentist | 1402 Argillite Road, Flatwoods, KY 41139 | 2007-02-27 |
| 1932253036 | Robert Eugene Wagner | Chiropractor | 10324 Canyon Rd East, #105, Puyallup, WA 98373 | 2007-01-23 |
| 1164599700 | Robert Frederick Wagner | Dentist | 2803 Ne Everett St, Portland, OR 97232-3246 | 2006-11-29 |
| 1306925243 | Robert P Wagner | Dentist | 1216 16th St W, Suite 34, Billings, MT 59102-4100 | 2006-11-02 |
| Street Address |
333 N 2ND ST SUITE 305 |
| City | NILES |
| State | MI |
| Zip Code | 49120-2258 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790838811 | Charles Michael Smith | Psychologist | 333 N 2nd St, Suite # 304, Niles, MI 49120-2258 | 2007-01-19 |
| 1720362841 | M Longley Counseling and Consulting Services, Pllc | Counselor | 333 N 2nd St, Suite 303, Niles, MI 49120-2258 | 2011-10-07 |
| 1043470891 | Thomson's Physical Therapy | Clinic/Center | 333 N 2nd St, Suite 308, Niles, MI 49120-2258 | 2008-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093285652 | The Caerus Group LLC | Clinic/Center | 732 S. 11th St #197, Niles, MI 49120 | 2018-11-27 |
| 1306316971 | Vicki L Yarbro | Physical Therapist | 6 Longmeadow Village Dr. Suite 3, Niles, MI 49120 | 2018-11-27 |
| 1063831469 | Aaron Joseph Lanning | Nurse Practitioner | 42 N Saint Joseph Ave Ste 300, Niles, MI 49120 | 2014-04-14 |
| 1740601186 | Terrianne Klaeren | Occupational Therapist | 1009 Almaugus Drive, Niles, MI 49120 | 2014-01-03 |
| 1124469366 | All Needs Senior Services, Inc. | Home Health | 1723 Pucker Street Dr, Suite A, Niles, MI 49120 | 2013-07-16 |
| 1902105034 | Nile Family Pharmacy LLC | Pharmacy | 70 E. State St., Niles, MI 49120 | 2011-03-15 |
| 1629240734 | Karen L Palmer | Counselor | 115 S St Joseph Ave, Niles, MI 49120 | 2008-03-28 |
| 1124218391 | Melissa A Longley | Social Worker | 333 N. Second Street, Suite 303, Niles, MI 49120 | 2007-07-25 |
| 1841410727 | Periza Zaninovic | Dentist | 123 Marmont Street, Niles, MI 49120 | 2007-04-26 |
| 1477629087 | Stephen Williams Tankersley | Dentist | 226 S Lincoln Ave, Niles, MI 49120 | 2006-11-27 |
| Find all providers in zip 49120 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568740256 | Josie Maria Dejong | Counselor | 1138 Fisk St, Niles, MI 49120-9532 | 2011-07-28 |
| 1912177338 | David Michael Kotoske | Counselor | 227 1/2 E Main St, Suite #208, Niles, MI 49120-2377 | 2008-03-03 |
| 1003999798 | Rosalie T Applebaum | Counselor | 7027 W Carol Ave, Niles, IL 60714-2149 | 2006-10-24 |
| 1255379012 | Barry Isaacson | Counselor | 8057 W Churchill Ave, Niles, IL 60714-1512 | 2006-06-03 |
| 1104289925 | Amanda Davis | Counselor | 165 E Park Ave, Niles, OH 44446-2352 | 2016-03-30 |
| 1851764245 | Lindsay Erin Devecchio | Counselor | 165 E Park Ave, Niles, OH 44446-2352 | 2015-11-05 |
| 1952778284 | David Earl Young | Counselor | 165 E Park Ave, Niles, OH 44446-2352 | 2015-08-21 |
| 1245611649 | Barbara Snow | Counselor | 165 E Park Ave, Niles, OH 44446-2352 | 2015-06-11 |
| 1669861241 | Ann Renee Bair | Counselor | 165 E Park Ave, Niles, OH 44446-2352 | 2015-01-20 |
| 1992109979 | Clarissa Willrich | Counselor | 165 E Park Ave, Niles, OH 44446-2352 | 2014-10-20 |
| Find all providers in NILES | ||||
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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.