JENNIFER WAGNER


Address: 702 Holly St, Atlanta, TX 75551-2308
Phone: 9032787795

JENNIFER WAGNER (NPI# 1508392135) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1508392135
Entity Type Individual
Full Name JENNIFER WAGNER
Credential LPC, LCDC
Practice Address 702 Holly St
Atlanta
TX 75551-2308
Mailing Address Po Box 777
Atlanta
TX 75551-0777
Practice Telephone 9032787795
Enumeration Date 2017-05-02
Last Update Date 2020-08-03
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
13846 TX Behavioral Health & Social Service Providers
Y 101YP2500X Counselor
Specialization: Professional
78248 TX Behavioral Health & Social Service Providers

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Office Location

Street Address 702 HOLLY ST
City ATLANTA
State TX
Zip Code 75551-2308

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1346879921 Wendy Sue Willoughby Pharmacy Technician 201 Us Hwy 59, Atlanta, TX 75551 2020-04-06
1689154759 Bobbye Francene Rankin Physical Therapy Assistant 109 Cr 3544, Atlanta, TX 75551 2018-08-18
1447668538 Winnie-stowell Hospital District Skilled Nursing Facility 1104 S. William Street, Atlanta, TX 75551 2014-08-01
1912176983 Glenna B Frost Speech-Language Pathologist 1001 West Main Street, Atlanta, TX 75551 2008-02-25
1043438823 Shelia Kaye Langbartels Optometrist 201 Hwy. 59 South, Atlanta, TX 75551 2007-04-24
1598838583 Tim C Hogan Dentist 402 S William St, Hogan Dental Clinic, Atlanta, TX 75551 2006-11-16
1003991290 Jimmy Glenn Stillwell Nurse Anesthetist, Certified Registered 1007 S Williams, Atlanta Memorial Hospital, Atlanta, TX 75551 2006-10-26
1336248376 Miles Drug Company Pharmacist 122 N East St, Atlanta, TX 75551 2006-09-22
1417050667 Danny Warren Addington Dentist 307 East Hiram, Atlanta, TX 75551 2006-09-06
1912917899 Atlanta Nursing Homes Inc. Skilled Nursing Facility 200 Live Oak, Atlanta, TX 75551 2006-08-09
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Taxonomy Information

Taxonomy Code 101YP2500X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Professional

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
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1205444718 Vanessa Lorraine Elizabeth Johnson Counselor 1388 Gates Cir Se, Atlanta, GA 30316-4092 2020-07-21
1891303426 Cheryl E Williams Counselor 1870 The Exchange, Suite 200 - 361, Atlanta, GA 30339 2020-07-20
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1881210201 Destiny Winters Counselor 900 Dekalb Ave Ne Ste K, Atlanta, GA 30307-2501 2020-06-22
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Competitor

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City ATLANTA
Zip Code 75551

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Dataset Information

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.

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