Kristi Deanna Waggener, LAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

733 Issued in LA

Practice address

Unit 6 Meadow Lane
Central la State Hospital - Red River Treatment Center
Pineville, LA 71360

Phone

(318) 484-6609

Fax

(318) 487-5703

NPI assigned

Oct 4, 2006

Last updated

Oct 31, 2024By 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

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.

• Alexandria Counseling, LLC

  • Social Worker
  • Alexandria, LA
  • NPI 1184358483

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1174618813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 HIGHWAY 115",
            "city": "DEVILLE",
            "state": "LA",
            "postal_code": "71328",
            "telephone_number": "318-466-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIT 6 MEADOW LANE",
            "address_2": "CENTRAL LA STATE HOSPITAL - RED RIVER TREATMENT CENTER",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "71360",
            "telephone_number": "318-484-6609",
            "fax_number": "318-487-5703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGGENER",
        "first_name": "KRISTI",
        "middle_name": "DEANNA",
        "name_prefix": "Mrs.",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "LA",
            "license": "733",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Villemarette, PT
• Lauren McMichael Vines, PHD
• Benjamin F Virden Jr., L.A.C.
• Vizzabol LLC
• Charlotte Smith Vroman
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0075)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-3736)
• Wal-Mart Stores Louisiana, LLC (Vision Center 30-0075)
• Jessica Waldron
• Walgreen Co (Walgreens #09526)

• Addiction (Substance Use Disorder) Counselor in Pineville, LA
• Providers in Pineville, LA by specialty
• Addiction (Substance Use Disorder) Counselor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; 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.