Active NPI
Hayley Wagner
- Mental Health Counselor
- Brewster, NY
National Provider Identifier
1053032185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 115864-01
- Practice address
- 400 Doansburg Rd
Brewster, NY 10509-5902 - Phone
- (845) 279-2995
- NPI assigned
- Sep 7, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 115864-01 | NY | Primary |
Addresses
Primary practice location
400 Doansburg Rd
Brewster, NY 10509-5902
Mailing address
51 Deans Bridge Rd
Somers, NY 10589-2610
Phone (845) 279-2995
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 |
|---|---|---|---|
| 115864-01 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662508800000",
"number": "1053032185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "51 DEANS BRIDGE RD",
"city": "SOMERS",
"state": "NY",
"postal_code": "105892610",
"telephone_number": "845-279-2995"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 DOANSBURG RD",
"city": "BREWSTER",
"state": "NY",
"postal_code": "105095902",
"telephone_number": "845-279-2995"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "HAYLEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-07",
"last_updated": "2022-09-07",
"certification_date": "2022-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "115864-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brewster, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.