Active NPI
Chavonne Wagner, LPC
- Professional Counselor
- Hamilton, OH
National Provider Identifier
1194233270
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- E.2303947
- Practice address
- 1100 Eaton Ave
Hamilton, OH 45013-1403 - Phone
- (513) 499-5266
- NPI assigned
- Jan 11, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | E.2303947 | OH | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LICDC.162685 | OH |
Addresses
Primary practice location
1100 Eaton Ave
Hamilton, OH 45013-1403
Mailing address
28 Danielle CT
Hamilton, OH 45013-5014
Phone (513) 499-5266
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 |
|---|---|---|---|
| LICDC.162685 | OH | MD | Addiction (Substance Use Disorder) Counselor |
| E.2303947 | OH | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728691200000",
"number": "1194233270",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 DANIELLE CT",
"city": "HAMILTON",
"state": "OH",
"postal_code": "450135014",
"telephone_number": "513-499-5266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 EATON AVE",
"city": "HAMILTON",
"state": "OH",
"postal_code": "450131403",
"telephone_number": "513-499-5266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "CHAVONNE",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-01-11",
"last_updated": "2024-10-12",
"certification_date": "2024-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "E.2303947",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "LICDC.162685",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hamilton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.