NICOLE WAGONER (NPI# 1477015881) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477015881 |
| Entity Type | Individual |
| Full Name | NICOLE WAGONER |
| Credential | LPCA |
| Practice Address |
2407 Grace Ave # 20 New Bern NC 28562-4416 |
| Mailing Address |
1 Linksiders Rd New Bern NC 28562-9541 |
| Practice Telephone | 9105204316 |
| Mailing Telephone | 9105204316 |
| Enumeration Date | 2019-04-03 |
| Last Update Date | 2019-04-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | A14357 | NC | Behavioral Health & Social Service Providers |
| Street Address |
2407 GRACE AVE # 20 |
| City | NEW BERN |
| State | NC |
| Zip Code | 28562-4416 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235741943 | Benchmark Physical Therapy of Nc, LLC | Occupational Therapist | 2026 Waterscape Way Ste 13, New Bern, NC 28562 | 2020-08-24 |
| 1023677234 | Katie Rebecca Masters Dmd Pllc | Dentist | 2900 Doctor M L K Jr. Blvd, New Bern, NC 28562 | 2019-06-11 |
| 1093281750 | Try-care LLC | Mechanotherapist | 37 Shoreline Dr, New Bern, NC 28562 | 2018-10-22 |
| 1376021949 | Maykin Kimberly Boyd | Social Worker | 1405 A South Glenburnie Rd, New Bern, NC 28562 | 2018-08-05 |
| 1770069288 | Rebecca Ann Anderson Bright | Counselor | 3435 Belmont Blvd, New Bern, NC 28562 | 2018-07-17 |
| 1841799814 | Dallin Page | Physical Therapist | 2111 Neuse Blvd Suite K, New Bern, NC 28562 | 2018-02-06 |
| 1467960476 | Randolph Ntoko Esabe | Pharmacist | 258 Station House Rd, New Bern, NC 28562 | 2018-01-12 |
| 1881100568 | Reid Family Eye Care, Od, Pllc | Optometrist | 3105 Doctor M.l.k. Jr. Blvd, New Bern, NC 28562 | 2017-12-18 |
| 1851742050 | Harris Teeter, LLC | Durable Medical Equipment & Medical Supplies | 2032 Waterscape Way, New Bern, NC 28562 | 2016-06-29 |
| 1609241868 | Victor Montoyaamaya | Military Health Care Provider | 3331 Hardee Farms Dr, New Bern, NC 28562 | 2015-12-14 |
| Find all providers in zip 28562 | ||||
| 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 |
|---|---|---|---|---|
| 1871101436 | Delzora Mae Clark | Counselor | 211 Walton Dr, New Bern, NC 28562-2309 | 2020-07-20 |
| 1558718965 | Kyle Slough | Counselor | 25 Harbor Walk, New Bern, NC 28562-8902 | 2016-05-16 |
| 1912372558 | Melissa Grushinski | Counselor | 1001b Neuse Dr, New Bern, NC 28560-6541 | 2015-12-08 |
| 1679771737 | Bronwyn Blair Gamon | Counselor | 517 Blades Ave, New Bern, NC 28560-3101 | 2007-07-10 |
| 1275145997 | Pathways Human Services of North Carolina, LLC | Counselor | 1403 Mccarthy Blvd, New Bern, NC 28562-2049 | 2020-08-24 |
| 1184159691 | Needham Fields | Counselor | 1430 Mccarthy Blvd, New Bern, NC 28562-2002 | 2017-04-23 |
| 1316321334 | Lisa Robinson Barrow | Counselor | 317d Pollock St, Suite # 4, New Bern, NC 28560-4989 | 2015-07-20 |
| 1548664287 | Access Family Services, Inc. | Counselor | 2117 S Glenburnie Rd, New Bern, NC 28562-2280 | 2014-10-09 |
| 1568764710 | Robert Webster | Counselor | 1900 Us Highway 70 E Ste C, New Bern, NC 28560-6818 | 2010-11-20 |
| 1750619219 | Margaret Ann Minsk | Counselor | 3010 Trent Rd, New Bern, NC 28562-5735 | 2009-11-20 |
| Find all providers in NEW BERN | ||||
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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.