STACEY WAGNER (NPI# 1780041582) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780041582 |
| Entity Type | Individual |
| Full Name | STACEY WAGNER |
| Practice Address |
1862 N Louisville Ave Tulsa OK 74115-4823 |
| Practice Telephone | 9186956774 |
| Mailing Telephone | 9186956774 |
| Enumeration Date | 2016-01-25 |
| Last Update Date | 2016-01-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | OK | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194946889 | Stacey Lynn Wagner | Social Worker | 1112 Nodak Dr S Ste 200, Fargo, ND 58103-2366 | 2007-05-01 |
| 1801497482 | Stacey Wagner | Pharmacist | 3001 Broadway Ave, Yankton, SD 57078-4890 | 2020-11-02 |
| Street Address |
1862 N LOUISVILLE AVE |
| City | TULSA |
| State | OK |
| Zip Code | 74115-4823 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538698899 | Pateisha Royal | Counselor | 7813 E. Independence St., Tulsa, OK 74115 | 2017-06-08 |
| 1154788750 | Heather Sisson-white | Case Manager/Care Coordinator | 132 N. Marion Ave, Tulsa, OK 74115 | 2016-01-27 |
| 1427234004 | American Current Care P.a. | Clinic/Center | 1541 North Sheridan Road, Tulsa, OK 74115 | 2008-01-14 |
| 1205031317 | Veera Aparanji Kaja | Dentist | 6801 E. Admiral Place, Tulsa, OK 74115 | 2007-06-19 |
| 1922137926 | Gregory L Mitchell | Preventive Medicine | 1515 N Harvard, Suite B, Tulsa, OK 74115 | 2007-03-05 |
| 1215942602 | G Chris Bussman | Dentist | 6716 E Pine, Tulsa, OK 74115 | 2006-07-31 |
| 1205870912 | Board of Regents of The University of Oklahoma Ou Physicians Tulsa | Family Medicine | Bcchs Celia Clinton Elementary, 1740 N. Harvard Ave., Tulsa, OK 74115 | 2006-06-15 |
| 1356853832 | Phoenix Soleil-maria Cooper | Case Manager/Care Coordinator | 3641 E 36th St N, Tulsa, OK 74115-1702 | 2017-10-24 |
| 1215380449 | Taleya Mayberry | Case Manager/Care Coordinator | 4115 E 36th St N, Tulsa, OK 74115-1709 | 2016-07-23 |
| 1104925619 | Marsha Ann Basner | Nutritionist | 3324 E 30th Pl N, Tulsa, OK 74115-2421 | 2006-09-21 |
| Find all providers in zip 74115 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437761004 | Ashley Jane Runnells | Counselor | 4867 S Sheridan Rd Ste 712a, Tulsa, OK 74145-5721 | 2020-08-17 |
| 1598316168 | Ryan David Sharpe | Counselor | 8218 S 77th East Ave Apt 1082, Tulsa, OK 74133-3966 | 2019-09-25 |
| 1588137780 | Hailee Dean Monroe | Counselor | 4103 S Yale Ave, Tulsa, OK 74135-6002 | 2019-01-10 |
| 1104308212 | Tawnya Denise Henderson | Counselor | 223 E Woodrow Pl, Tulsa, OK 74106-3729 | 2018-09-05 |
| 1003395617 | Crystal L Moore | Counselor | 8725 Point Dr, Tulsa, OK 74131-4028 | 2018-08-14 |
| 1386146660 | Breanna White | Counselor | 7541 S Mingo Rd Apt 7154, Tulsa, OK 74133-3384 | 2018-03-02 |
| 1699285015 | Christina M Smalley | Counselor | 600 Civic Ctr, Tulsa, OK 74103-3829 | 2017-10-11 |
| 1700395902 | Rachel Lynn Richardson | Counselor | 5800 E Skelly Dr Ste 1100, Tulsa, OK 74135-6448 | 2017-09-20 |
| 1023538014 | Milton Dean IIi | Counselor | 1234 N Rosedale, Tulsa, OK 74127 | 2017-06-21 |
| 1659800019 | Welena-phay Kamamma Boren | Counselor | 4636 S Harvard Avenue, Tulsa, OK 74135 | 2017-06-08 |
| Find all providers in TULSA | ||||
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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.