Active NPI
Grace Wagner, PROFESSIONAL COUNSEL
- Counselor
- Monroeville, PA
National Provider Identifier
1366847592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 007839
- Practice address
- 4314 Old William Penn Highway
Suite 204
Monroeville, PA 15146 - Phone
- (412) 352-6634
- Fax
- (412) 829-7240
- NPI assigned
- Oct 30, 2014
- Last updated
- Dec 19, 2017
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 007839 | PA | Primary |
Addresses
Primary practice location
4314 Old William Penn Highway
Suite 204
Monroeville, PA 15146
Mailing address
4314 Old William Penn Highway
Suite 204
Monroeville, PA 15146
Phone (412) 352-6634
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 |
|---|---|---|---|
| 007839 | PA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1414627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513641600000",
"number": "1366847592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4314 OLD WILLIAM PENN HIGHWAY",
"address_2": "SUITE 204",
"city": "MONROEVILLE",
"state": "PA",
"postal_code": "15146",
"telephone_number": "412-352-6634",
"fax_number": "412-829-7240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4314 OLD WILLIAM PENN HIGHWAY",
"address_2": "SUITE 204",
"city": "MONROEVILLE",
"state": "PA",
"postal_code": "15146",
"telephone_number": "412-352-6634",
"fax_number": "412-829-7240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "GRACE",
"credential": "PROFESSIONAL COUNSEL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-10-30",
"last_updated": "2017-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "PA",
"license": "007839",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monroeville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.