Active NPI
Joseph Michael Wagner, LPC-S
- Professional Counselor
- Metairie, LA
National Provider Identifier
1043478290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 4420
- Practice address
- 3350 Ridgelake Dr # 87
Metairie, LA 70002-3836 - Phone
- (504) 293-0021
- NPI assigned
- May 23, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 4420 | LA | Primary |
Addresses
Primary practice location
3350 Ridgelake Dr # 87
Metairie, LA 70002-3836
Mailing address
333 Highway Dr # B
Jefferson, LA 70121-3414
Phone (504) 237-5830
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4420 | LA | MD | Professional Counselor |
Networks
- LA PPO C-SNP
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594252800000",
"number": "1043478290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 HIGHWAY DR # B",
"city": "JEFFERSON",
"state": "LA",
"postal_code": "701213414",
"telephone_number": "504-237-5830"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3350 RIDGELAKE DR # 87",
"city": "METAIRIE",
"state": "LA",
"postal_code": "700023836",
"telephone_number": "504-293-0021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "JOSEPH",
"middle_name": "MICHAEL",
"credential": "LPC-S",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-05-23",
"last_updated": "2020-07-09",
"certification_date": "2020-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "LA",
"license": "4420",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Metairie, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.