Jean L. Wagner, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E.1200270 Issued in OH

Practice address

113 S. Beech St.
Bryan, OH 43506

Phone

(419) 633-3333

Fax

(419) 754-2255

NPI assigned

Jun 20, 2013

Sex

Female

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

Not listed in the public Medicare enrollment file

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.

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 and National Provider Directory roles.

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  • NPI 1184243388
  NPD (past)

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

{
    "created_epoch": "1371686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1326487679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 S. BEECH ST.",
            "city": "BRYAN",
            "state": "OH",
            "postal_code": "43506",
            "telephone_number": "419-633-3333",
            "fax_number": "419-754-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 S. BEECH ST.",
            "city": "BRYAN",
            "state": "OH",
            "postal_code": "43506",
            "telephone_number": "419-633-3333",
            "fax_number": "419-754-2255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "230 W Sandusky St",
            "address_purpose": "LOCATION",
            "city": "Findlay",
            "state": "OH",
            "postal_code": "458403218",
            "country_code": "US",
            "telephone_number": "419-423-7812 x121",
            "fax_number": "419-423-9877",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "JEAN",
        "middle_name": "L.",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-20",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.0025485",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.1200270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cornel C Van Gorp, MD
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• Jaganmohan R Vemulapalli, MD
• Divya Goutam Vijendra, M.D.
• Hannah Louise Vollmer, OD
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Walgreen Co
• Shea Micheal Walkup, D.D.S.
• Carl N Walz, MD

• Professional Counselor in Bryan, OH
• Providers in Bryan, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.