MRS. KATHLEEN ANN WAGNER (NPI# 1982969754) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982969754 |
| Entity Type | Individual |
| Full Name | MRS. KATHLEEN ANN WAGNER |
| Credential | MA, LPC |
| Practice Address |
145 Emerald Ln Fayetteville GA 30214-4234 |
| Practice Telephone | 6788715927 |
| Mailing Telephone | 6788715927 |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2020-05-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
LPC006769 | GA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417147984 | Kathleen J. Wagner | Social Worker | 3021 6th Avenue North, Suite 106, Billings, MT 59101-2223 | 2007-07-30 |
| 1952342933 | Kathleen Therese Wagner | Family Medicine | 4920 W Lone Mountain Rd, Las Vegas, NV 89130 | 2006-06-09 |
| 1841728581 | Kathleen Wagner | Speech-Language Pathologist | 1935 County Road B2 W Ste 100, Roseville, MN 55113-2722 | 2017-05-25 |
| 1700210176 | Kathleen Wagner | Social Worker | 1332 Pickens St, Columbia, SC 29201-3430 | 2013-08-21 |
| 1871879452 | Kathleen Marie Wagner | Occupational Therapy Assistant | 3291 S Thompson St Ste C103, Springdale, AR 72764-7343 | 2011-10-27 |
| 1588965354 | Kathleen Wagner | Licensed Practical Nurse | 2250 Hickory Rd, Plymouth Meeting, PA 19462-1047 | 2010-11-10 |
| 1518292515 | Kathleen M Wagner | Occupational Therapist | 9129 Monroe Rd, Suite 100, Charlotte, NC 28270-2429 | 2009-10-08 |
| 1487822011 | Kathleen Q. Wagner | Physical Therapist | 2829 Lititz Pike, Lancaster, PA 17601-3321 | 2008-02-17 |
| 1740397041 | Kathleen Mary Wagner | Nurse Practitioner | 1223 Gateway Drive, Melbourne, FL 32901-2607 | 2006-08-23 |
| 1639180110 | Kathleen Wagner | Clinical Nurse Specialist | 13000 Bruce B Downs Blvd, Tampa, FL 33612-4745 | 2006-08-10 |
| Street Address |
145 EMERALD LN |
| City | FAYETTEVILLE |
| State | GA |
| Zip Code | 30214-4234 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
| 1073139317 | Tyisha Salter Scott | Counselor | 110 Habersham Drive, Suite 142, Fayetteville, GA 30214 | 2020-06-23 |
| 1194341412 | Camille Franncine Bolton | Physical Therapist | 500 Floy Farr Parkway, Suite 303, Fayetteville, GA 30214 | 2020-06-23 |
| 1205465895 | Gillian Vaughan Heard | Physician Assistant | 1275 Ga-54 #201, Fayetteville, GA 30214 | 2020-04-06 |
| 1881234557 | Peach Fits,inc | Mastectomy Fitter | 285 Glynn Street South, Suites 102 and 104, Fayetteville, GA 30214 | 2020-01-10 |
| 1255981072 | Delta Healthcare Providers | Clinic/Center | 1275 W Lanier Ave, #200, Fayetteville, GA 30214 | 2019-09-13 |
| 1861965592 | Hierarchy for Wellness | Specialist | 805 S Glynn St Bldg 127 142, Fayetteville, GA 30214 | 2019-01-04 |
| 1356810634 | Fayette Dental Group PC | Clinic/Center | 720 W Lanier Ave, Fayetteville, GA 30214 | 2018-11-16 |
| 1891263299 | Mattie Mae Farmer Clark | Specialist/Technologist, Other | Piedmont Fayette Hospital, 1255 Highway 54 West, Fayetteville, GA 30214 | 2018-11-05 |
| 1093293607 | Allyson Holland | Pharmacist | 880 Highway 85 South, Fayetteville, GA 30214 | 2018-08-06 |
| Find all providers in zip 30214 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841899986 | Cynthia Hrdlichka | Counselor | 2224 E Elaine Ave, Fayetteville, AR 72703-4507 | 2020-10-20 |
| 1568069169 | Blaire Bradbury | Counselor | 1466 N Desoto Pl, Fayetteville, AR 72703-1953 | 2020-10-06 |
| 1588294631 | Puzzle Collaborative | Counselor | 34 W Colt Square Dr Ste 1, Fayetteville, AR 72703-2888 | 2020-01-16 |
| 1700421724 | Waylon Vande Hoef | Counselor | 1925 N Green Acres Rd, Fayetteville, AR 72703-2617 | 2019-11-13 |
| 1730640137 | Sherrita Hedgepeth | Counselor | 1351 Glen Iris Dr Apt 105, Fayetteville, NC 28314-6190 | 2019-03-28 |
| 1689139362 | Resiliency Behavioral Health Services LLC | Counselor | 145 Govenors Square, Ste A, Fayetteville, GA 30269 | 2019-02-06 |
| 1073006540 | Rona Gooden | Counselor | 706 Dandridge Dr, Fayetteville, NC 28303-2017 | 2018-06-10 |
| 1194229245 | The Welling Place LLC | Counselor | 2525 Raeford Rd Ste C, Fayetteville, NC 28305-5092 | 2018-03-22 |
| 1104320399 | Tia Porterfield | Counselor | 2018 Fort Bragg Rd Ste 112a, Fayetteville, NC 28303 | 2018-03-21 |
| 1376062539 | Monique R Darnell | Counselor | 320 W. Lanier Avenue Ste 200, Fayetteville, GA 30214 | 2017-09-19 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 30214 |
Please comment or provide details below to improve the information on MRS. KATHLEEN ANN WAGNER.
| 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.