DR. CRAIG D. WAGGONER


Address: 4105 Kirkman St, Lake Charles, LA 70607-4603
Phone: 3374758022

DR. CRAIG D. WAGGONER (NPI# 1578517439) 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) 1578517439
Entity Type Individual
Full Name DR. CRAIG D. WAGGONER
Credential PHD, MPAP
Practice Address 4105 Kirkman St
Lake Charles
LA 70607-4603
Practice Telephone 3374758022
Practice Fax Number 3374758054
Mailing Telephone 3374758022
Mailing Fax Number 3374758054
Enumeration Date 2006-05-22
Last Update Date 2013-02-07
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TP0016X Psychologist
Specialization: Prescribing (Medical)
MPAP.000029 LA Behavioral Health & Social Service Providers

Office Location

Street Address 4105 KIRKMAN ST
City LAKE CHARLES
State LA
Zip Code 70607-4603

Providers in the same location

NPI Name Taxonomy Address Enumeration
1659988343 Katie Bruce Pharmacist 4105 Kirkman St, Lake Charles, LA 70607-4603 2020-09-26
1598245623 Imperial Calcasieu Human Services Authority Clinic/Center 4105 Kirkman St, Lake Charles, LA 70607-4603 2018-08-17
1730698838 Rebecca Becky Perry Social Worker 4105 Kirkman St, Lake Charles, LA 70607-4603 2017-09-21
1538566336 Troy Barrow Registered Nurse 4105 Kirkman St, Lake Charles, LA 70607-4603 2014-11-24
1992101240 Clint Dupre Licensed Practical Nurse 4105 Kirkman St, Lake Charles, LA 70607-4603 2014-11-14
1386057891 Vicki Ann Lebleu Nurse Practitioner 4105 Kirkman St, Lake Charles, LA 70607-4603 2014-06-03
1750792248 Genoa Healthcare, LLC Pharmacy 4105 Kirkman St, Lake Charles, LA 70607-4603 2014-05-19
1376971200 Lexi Berryhill Social Worker 4105 Kirkman St, Lake Charles, LA 70607-4603 2013-11-01
1700127487 Dana Young Counselor 4105 Kirkman St, Lake Charles, LA 70607-4603 2013-03-06
1730420530 Sandy Marie Faulk Counselor 4105 Kirkman St, Lake Charles, LA 70607-4603 2013-03-05
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1710596283 Dakota Loosemore Student in an Organized Health Care Education/Training Program 800 East Mcneese Street, Lake Charles, LA 70607 2020-07-30
1467003822 Sarah Jane Walley Specialist/Technologist 800 E Mcneese Street, Lake Charles, LA 70607 2019-09-26
1770053902 Antonio Rivera Chiropractor 2625 Dillard Loop, Suite C, Lake Charles, LA 70607 2018-11-30
1851861330 Shannon Marie Melvin Specialist/Technologist 800 East Mcneese, Lake Charles, LA 70607 2018-11-28
1326517699 Vincent Michael Williams Specialist/Technologist 800 East Mcneese St, Lake Charles, LA 70607 2018-11-16
1396263356 Lake Area Physician Services LLC Durable Medical Equipment & Medical Supplies 10071 Hwy 385, Lake Charles, LA 70607 2017-08-30
1023556370 Heath Bryan Coleman, Dds of Louisiana II, A Professional Dental LLC Dentist 2625 Dillard Loop, Ste A, Lake Charles, LA 70607 2017-02-07
1750741880 Townsend Treatment Center, LLC Substance Abuse Rehabilitation Facility 635a Petro Point Dr, Lake Charles, LA 70607 2016-03-02
1194081414 Clint Nickolas Lincoln Family Medicine 10071 Gulf Hwy, Lake Charles, LA 70607 2012-04-11
1295976652 John Leroy Speer Dentist 3425 Louisiana Ave., Lake Charles, LA 70607 2009-03-16
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Taxonomy Information

Taxonomy Code 103TP0016X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Prescribing (Medical)

Taxonomy Definition

Those licensed psychologists who have completed specialized, post-doctoral training in psychopharmacology, passed a national proficiency examination in psychopharmacology, and who are authorized by state statute to prescribe medications, in accordance with their state law and state licensing authority, for the evaluation, diagnosis, management and treatment of mental, nervous, emotional, behavioral, and related disorders.
Notes: Source: Louisiana Academy of Medical Psychologists Note: Some states issue licenses under Medical Psychologist. [1/1/2007: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1861627465 Lakisha Shantell Williams Psychologist 1409 Kirkman St, Lake Charles, LA 70601-5344 2009-05-26
1104176825 Beyond Words, Inc. Psychologist 1409 Kirkman St, Lake Charles, LA 70601-5344 2012-09-11

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1790297182 George S. Park, Phd., Mp., A Psychology Corporation Psychologist 2285 Benton Rd Ste 401, Bossier City, LA 71111-7933 2017-10-25
1669887907 John Courtney LLC Psychologist 118 Terra Bella Blvd, Suite 101, Covington, LA 70433-8148 2014-06-25
1730520925 Faw Services, LLC Psychologist 223 Bellingrath Pl, Madisonville, LA 70447-3421 2013-07-16
1134418502 Psychological Health Care of South Louisiana Psychologist 1016 Houma St, Houma, LA 70360-4420 2011-04-06
1922234566 Felicia Ann Whiteman Psychologist 2331 Carey St, Slidell, LA 70458-3627 2009-06-10
1710101373 Rebecca Faye Nolan Psychologist 111 Carroll St, Shreveport, LA 71105-4203 2007-04-12
1013131267 Dr. Maria B. Cruse Apmg Psychologist 604 North Acadia Road, Suite 201, Thibodaux, LA 70301 2007-04-12
1093860371 Maxine Elizabeth Campbell-flint Psychologist 412 N 4th St, Suite 100, Baton Rouge, LA 70802-5523 2007-01-24
1104925932 Williams Consulting Inc. Psychologist 1410 Royal Ave, Monroe, LA 71201-5608 2006-09-21
1043247331 Bryan L Bolwahnn Psychologist 100 Gayven Dr, Ball, LA 71405-4903 2006-06-26
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Competitor

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City LAKE CHARLES
Zip Code 70607

Improve Information

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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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