Active NPI
Wendy Wagener
- Addiction (Substance Use Disorder) Counselor
- Waverly, MN
National Provider Identifier
1184548091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 301570
- Practice address
- 109 N Shore Dr
Waverly, MN 55390-5517 - Phone
- (320) 543-5686
- NPI assigned
- Aug 5, 2026
- Last updated
- Aug 5, 2026
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 301570 | MN | Primary |
Addresses
Primary practice location
109 N Shore Dr
Waverly, MN 55390-5517
Mailing address
550 Main Street Suite 190
New Brighton, MN 55112
Phone (320) 543-5686
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1785888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785888000000",
"number": "1184548091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "550 MAIN STREET SUITE 190",
"city": "NEW BRIGHTON",
"state": "MN",
"postal_code": "55112",
"telephone_number": "320-543-5686"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 N SHORE DR",
"city": "WAVERLY",
"state": "MN",
"postal_code": "553905517",
"telephone_number": "320-543-5686"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGENER",
"first_name": "WENDY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-08-05",
"last_updated": "2026-08-05",
"certification_date": "2026-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MN",
"license": "301570",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waverly, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.