Wagner Counseling PLLC Samantha Wagner Sole MBR

Primary specialty

Social WorkerTaxonomy code 104100000X

Legal business name

WAGNER COUNSELING PLLC SAMANTHA WAGNER SOLE MBR

Practice address

112 N 2ND St
Rockford, IL 61107-4051

Phone

(608) 313-4655

NPI assigned

Mar 11, 2025

Organization subpart

No

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

Authorized official

Name

Patty Nunez

Title

Credentialing Specialist

Phone

(312) 439-2321

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1741651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741651200000",
    "number": "1407655509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 N 2ND ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611074051",
            "telephone_number": "608-313-4655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 N 2ND ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611074051",
            "telephone_number": "608-313-4655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAGNER COUNSELING PLLC SAMANTHA WAGNER SOLE MBR",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-11",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A",
        "authorized_official_last_name": "NUNEZ",
        "authorized_official_first_name": "PATTY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "312-439-2321"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Vowles, L.P.C.
• Kaitlyn J Vranek, LCSW
• Monesa Catherine Vu, PHARMD
• Michelle Vurnovas, LCSW
• Erin J Wade, PH.D.
• Alan S. Wagner, M.D.
• Natalie J Wagner, OT
• Peggy Lynn Wagner, APN
• Samantha Wagner
• Samantha Elizabeth Wagner, APRN

• Social Worker in Rockford, IL
• Providers in Rockford, IL by specialty
• Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.