Kathyrn Ann Wagner, LADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

301935 Issued in MN

Practice address

1700 Technology Dr NE Suite 203 #2
Willmar, MN 56201-2295

Phone

(320) 905-6152

NPI assigned

Jul 18, 2017

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Recovery 4 Today PLLC

  • Substance Abuse Rehabilitation Facility
  • Willmar, MN
  • NPI 1619722675
  NPD
• Divine Hope Counseling

  • Substance Abuse Rehabilitation Facility
  • Willmar, MN
  • NPI 1003042656
  NPD (past)

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

{
    "created_epoch": "1500336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751846400000",
    "number": "1386167708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 TECHNOLOGY DR NE SUITE 203 #2",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562012295",
            "telephone_number": "320-905-6152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 TECHNOLOGY DR NE SUITE 203 #2",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562012295",
            "telephone_number": "320-905-6152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "KATHYRN",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-18",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "301935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shane Paul Volk, CRNA
• Laurie Vollan, MSW, LICSW, SSW
• Mary Ellen Louise Vomacka, MD
• Gretchen Mary Vonrueden, DDS
• Lyndsie Jo Voorhees, LPCC
• Wal-Mart Stores, Inc
• Jessica Waldemarsen, LICSW
• Walgreen Co
• Walmart Inc.
• Raquel Kay Walsh Jahnke, DO, MBA

• Addiction (Substance Use Disorder) Counselor in Willmar, MN
• Providers in Willmar, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.