Stephen Lee Wagner, ED.S.

Primary specialty

School PsychologistTaxonomy code 103TS0200X

License

KU1007163 Issued in OH

Practice address

38720 Saltwell Rd
Lisbon, OH 44432-8303

Phone

(330) 424-9591

Fax

(330) 424-9481

NPI assigned

Sep 15, 2015

Last updated

Sep 15, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Columbiana County Educational Service Center

  • Local Education Agency (LEA)
  • Lisbon, OH
  • NPI 1346480084
  NPD (past)

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

{
    "created_epoch": "1442275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442275200000",
    "number": "1114396694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38720 SALTWELL RD",
            "city": "LISBON",
            "state": "OH",
            "postal_code": "444328303",
            "telephone_number": "330-424-9591",
            "fax_number": "330-424-9481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38720 SALTWELL RD",
            "city": "LISBON",
            "state": "OH",
            "postal_code": "444328303",
            "telephone_number": "330-424-9591",
            "fax_number": "330-424-9481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "STEPHEN",
        "middle_name": "LEE",
        "credential": "ED.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-15",
        "last_updated": "2015-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "OH",
            "license": "KU1007163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• VI Sano Healthcare LLC
• Christa Michele Viets
• Rebekah Viets
• Shawn Eric Viets
• Bonnie Virden, QMHS
• David Wallenhurst, AAS
• Matthew Ray Warren
• Taylor Watson, QMHS
• Anthony James Watt, MA, LPCC, LICDC
• Larisa Rachael Watt, BA, LCDCII, QBHS

• School Psychologist in Lisbon, OH
• Providers in Lisbon, OH by specialty
• School Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2015; 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.