Abigail Rae Wagner, LPC, LADC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2898 Issued in MN

Practice address

815 Highway 10 Ste 102
Elk River, MN 55330-5204

Phone

(763) 274-0510

NPI assigned

Jun 18, 2018

Last updated

Aug 8, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Abigail Rae Charlson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nystrom & Associates, LTD

  dba Sagent Behavioral Health

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  NPD
• Family Support Services Inc.

  dba Sagent Behavioral Health

  • Mental Health Counselor
  • New Brighton, MN
  • NPI 1467549220
  NPD (past)
• The Creative Therapy Center, LLC

  • Marriage & Family Therapist
  • Elk River, MN
  • NPI 1609196898
  NPD (past)

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

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786147200000",
    "number": "1033603527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 HIGHWAY 10 STE 102",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553305204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 HIGHWAY 10 STE 102",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553305204",
            "telephone_number": "763-274-0510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "207 Jefferson Blvd",
            "address_purpose": "LOCATION",
            "city": "Big Lake",
            "state": "MN",
            "postal_code": "553094667",
            "country_code": "US",
            "telephone_number": "763-367-6080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "ABIGAIL",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "LPC, LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-18",
        "last_updated": "2026-08-08",
        "certification_date": "2026-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "305134",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "2898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ABIGAIL",
            "last_name": "CHARLSON",
            "middle_name": "RAE",
            "credential": "LADC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Mental Health Counselor in Elk River, MN
• Providers in Elk River, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.