Brian Joseph Wagner, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149025667 Issued in IL

Practice address

55 E Loop Rd Ste 301
Wheaton, IL 60189-1938

Phone

(630) 428-7890

Fax

(630) 428-7891

NPI assigned

Sep 13, 2023

Last updated

Apr 23, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

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.

• Edgewood Clinical Services, P.C.

  dba LifeStance

  • Psychologist
  • Naperville, IL
  • NPI 1295914646

  Clinical

  Medicare reassignment NPD
• Otte Practice PLLC

  dba Ellie Mental Health - Naperville

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Naperville, IL
  • NPI 1477279651
  Medicare reassignment NPD

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

{
    "created_epoch": "1694563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776902400000",
    "number": "1336926393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 E LOOP RD STE 301",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601891938",
            "telephone_number": "630-428-7890",
            "fax_number": "630-428-7891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 E LOOP RD STE 301",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601891938",
            "telephone_number": "630-428-7890",
            "fax_number": "630-428-7891"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3040 Finley Rd Ste 220",
            "address_purpose": "LOCATION",
            "city": "Downers Grove",
            "state": "IL",
            "postal_code": "605155714",
            "country_code": "US",
            "telephone_number": "877-381-6538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "BRIAN",
        "middle_name": "JOSEPH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-13",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149025667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Von Bampus, PT, DPT
• Jennifer Vreisema
• Vulnera Medicus Inc
• W. Patrick Zeller MD LTD
• Dori Jean Wachowski, RDH
• Arielle Wainman, LPC
• Bradley William Waite
• Warren F. Wakerlin, D.D.S.,M.S.
• Kaitlyn Walderbach
• Walgreen Co (Walgreens # 13861)

• Clinical Social Worker in Wheaton, IL
• Providers in Wheaton, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2026; 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.