Active NPI
Dana Beth Wagner, PSYD
- Clinical Psychologist
- Naperville, IL
National Provider Identifier
1336457514
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071.006933
- Practice address
- 1819 Bay Scott Cir
Suite 109
Naperville, IL 60540-1129 - Phone
- (630) 357-2456
- Fax
- (630) 357-2482
- NPI assigned
- Sep 21, 2010
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 071.006933 | IL | Primary |
Addresses
Primary practice location
1819 Bay Scott Cir
Suite 109
Naperville, IL 60540-1129
Mailing address
1819 Bay Scott Cir
Suite 109
Naperville, IL 60540-1129
Phone (630) 357-2456
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 |
|---|---|---|---|
| 071.006933 | IL | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Samaritan Counseling Center | Past | Accepting new patients | |
| Samaritan Interfaith Counseling Center Inc. | Clinical | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Marriage & Family Therapist
- Winnetka, IL
- NPI 1841397353
-
- Clinical Psychologist
- Naperville, IL
- NPI 1497842983
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285027200000",
"number": "1336457514",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1819 BAY SCOTT CIR",
"address_2": "SUITE 109",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605401129",
"telephone_number": "630-357-2456",
"fax_number": "630-357-2482"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1819 BAY SCOTT CIR",
"address_2": "SUITE 109",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605401129",
"telephone_number": "630-357-2456",
"fax_number": "630-357-2482"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "DANA",
"middle_name": "BETH",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-21",
"last_updated": "2010-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071.006933",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Naperville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.