Phyliss Wagner, LPCC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CDCA.164771 Issued in OH

Practice address

842 Corporate Way Ste 850
Westlake, OH 44145-1537

Phone

(440) 296-2050

NPI assigned

Sep 28, 2017

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Wagner and Associates Mental Health Services LLCGroup PAC ID 4082060710, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wagner and Associates Mental Health Services LLC

  • Professional Counselor
  • Westlake, OH
  • NPI 1215525712
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1506556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1003325416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 WOODSTOCK DR",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "440121622",
            "telephone_number": "440-989-4987",
            "fax_number": "440-296-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "842 CORPORATE WAY STE 850",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441451537",
            "telephone_number": "440-296-2050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "107 Woodstock Dr",
            "address_purpose": "LOCATION",
            "city": "Avon Lake",
            "state": "OH",
            "postal_code": "440121622",
            "country_code": "US",
            "telephone_number": "440-296-2050",
            "fax_number": "440-246-0189",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24500 Center Ridge Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Westlake",
            "state": "OH",
            "postal_code": "441455604",
            "country_code": "US",
            "telephone_number": "440-522-9810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "PHYLISS",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-28",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.2001993",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.164771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "CDCA.164771",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "phyliss@wagnermentalhealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "107 Woodstock Dr",
            "city": "Avon Lake",
            "state": "OH",
            "country_code": "US",
            "postal_code": "440121622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Madelaine Baylee Waggy
• Satesh Waghray, MD
• Wagner and Associates Mental Health Services LLC
• Brianna Marie Wagner, MOT, OTR
• Janice Wagner, OTR/L
• Aziza A Wahby, DO
• Shokri A Wahib, DDS
• Natalie A Wahl
• Walden Healthcare, LLC.
• Walgreen Co

• Addiction (Substance Use Disorder) Counselor in Westlake, OH
• Providers in Westlake, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.