Benjamin Kent Wagner, LPC-MHSP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

7325 Issued in TN

Practice address

4012 Fort Henry Dr
Kingsport, TN 37663-2028

Phone

(423) 430-9687

NPI assigned

Aug 19, 2024

Last updated

Aug 19, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Group practices

Tri-Star Counseling, LLCGroup PAC ID 4486049384, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Tri-Star Counseling, LLC

  • Clinical Social Worker
  • Kingsport, TN
  • NPI 1184376741
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1724025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1255163283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1216 SEMINOLE DR APT 5",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376047154",
            "telephone_number": "423-470-4683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4012 FORT HENRY DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376632028",
            "telephone_number": "423-430-9687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "BENJAMIN",
        "middle_name": "KENT",
        "credential": "LPC-MHSP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-19",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": "7325",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "7325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendy Hyche Vogel, NP
• Bryan Justice Vrailas
• Duc Q Vu, M.D.
• Angela Ree Wackowski, PHARMD
• Beverly Jane Waddell, ANP, GCNS
• Laura Wagner
• Megan Elizabeth Wagner, FNP-C
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0742)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0599)
• Wal-Mart Stores East, LP (Vision Center 30-0599)

• Mental Health Counselor in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Mental Health Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.