ROBERT MICHAEL WAGNER


Address: 160 East Kellogg Blvd., Suite 8500, St. Paul, MN 55101
Phone: 6512663933

ROBERT MICHAEL WAGNER (NPI# 1982875852) 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) 1982875852
Entity Type Individual
Full Name ROBERT MICHAEL WAGNER
Credential LP
Practice Address 160 East Kellogg Blvd.
Suite 8500
St. Paul
MN 55101
Mailing Address 2703 Snowdrift Cir E
Maplewood
MN 55119-5993
Practice Telephone 6512663933
Mailing Telephone 6122722255
Enumeration Date 2008-03-18
Last Update Date 2008-03-18
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103T00000X Psychologist LP4010 MN Behavioral Health & Social Service Providers

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Office Location

Street Address 160 EAST KELLOGG BLVD.
SUITE 8500
City ST. PAUL
State MN
Zip Code 55101

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Taxonomy Information

Taxonomy Code 103T00000X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist

Taxonomy Definition

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Notes: Source: American Psychological Association [1/1/2007: modified definition]

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Competitor

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City ST. PAUL
Zip Code 55101

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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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