Individual provider Active NPI

Rebecca Louise Wagner, LMHC-D

  • Mental Health Counselor
  • Chappaqua, NY
National Provider Identifier
1164033759
Registry record updated Apr 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1 S Greeley Ave Ste 204
Chappaqua, NY 10514-3345
Phone
(914) 255-2075
NPI assigned
Aug 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NY Primary

Addresses

Primary practice location

1 S Greeley Ave Ste 204
Chappaqua, NY 10514-3345

Mailing address

1 S Greeley Ave Ste 204
Chappaqua, NY 10514-3345
Phone (914) 255-2075

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

Practice roles

OrganizationSpecialtyStatusNew patients
Branch Out Mental Health Counseling PLLC Mental Health CurrentSince Jan 5, 2025 Accepting new patients
Boston Childrens Health Physicians LLP PastSince Aug 1, 2020 Accepting new patients
Boston Children'S Health Physicians, LLP PastSince Sep 1, 2024 Accepting new patients

Locations

455 Tarrytown Rd
White Plains, NY 10607
Phone (914) 340-3340

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1597536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776902400000",
    "number": "1164033759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 S GREELEY AVE STE 204",
            "city": "CHAPPAQUA",
            "state": "NY",
            "postal_code": "105143345",
            "telephone_number": "914-255-2075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 S GREELEY AVE STE 204",
            "city": "CHAPPAQUA",
            "state": "NY",
            "postal_code": "105143345",
            "telephone_number": "914-255-2075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "REBECCA",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "credential": "LMHC-D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-16",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chappaqua, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.