Active NPI
M. Dianne Wages, LPC
- Mental Health Counselor
- Lagrange, GA
National Provider Identifier
1306802301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LPC004106
- Practice address
- 300 Medical Dr
M. Dianne Wages, LPC
Lagrange, GA 30240 - Phone
- (706) 885-0111
- Fax
- (706) 885-0607
- NPI assigned
- Apr 26, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPC004106 | GA | Primary |
Addresses
Primary practice location
300 Medical Dr
M. Dianne Wages, LPC
Lagrange, GA 30240
Mailing address
300 Medical Dr
M. Dianne Wages, LPC
Lagrange, GA 30240
Phone (706) 885-0111
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 337862151A | Medicaid | GA |
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 |
|---|---|---|---|
| LPC004106 | GA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210896000000",
"number": "1306802301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 MEDICAL DR",
"address_2": "M. DIANNE WAGES, LPC",
"city": "LAGRANGE",
"state": "GA",
"postal_code": "30240",
"telephone_number": "706-885-0111",
"fax_number": "706-885-0607"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 MEDICAL DR",
"address_2": "M. DIANNE WAGES, LPC",
"city": "LAGRANGE",
"state": "GA",
"postal_code": "30240",
"telephone_number": "706-885-0111",
"fax_number": "706-885-0607"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGES",
"first_name": "M.",
"middle_name": "DIANNE",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-04-26",
"last_updated": "2008-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "GA",
"license": "LPC004106",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "337862151A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lagrange, GA
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.