Active NPI
Michelle V Wagner, LPC, LCPC
- Professional Counselor
- Raytown, MO
National Provider Identifier
1467148213
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2022049325
- Practice address
- 8211 Sterling Ave
Raytown, MO 64138-2690 - Phone
- (816) 268-7330
- NPI assigned
- Apr 14, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 04107 | KS | |
| Professional Counselor | 101YP2500X | 2022049325 | MO | Primary |
Addresses
Primary practice location
8211 Sterling Ave
Raytown, MO 64138-2690
Mailing address
PO Box 844715
Kansas City, MO 64184-4715
Phone (417) 761-5214
Other practice location 1
17886 E 23rd St S
Independence, MO 64057-1840
Phone (816) 254-3652
Other practice location 2
8333 E Blue Pkwy
Kansas City, MO 64133-4750
Phone (816) 474-7677
Other names 1
- Michelle Waterman
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 |
|---|---|---|---|
| 04107 | KS | MD | Professional Counselor |
| 2022049325 | MO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786492800000",
"number": "1467148213",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 844715",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641844715",
"telephone_number": "417-761-5214",
"fax_number": "417-761-5065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8211 STERLING AVE",
"city": "RAYTOWN",
"state": "MO",
"postal_code": "641382690",
"telephone_number": "816-268-7330"
}
],
"practiceLocations": [
{
"address_1": "17886 E 23rd St S",
"address_purpose": "LOCATION",
"city": "Independence",
"state": "MO",
"postal_code": "640571840",
"country_code": "US",
"telephone_number": "816-254-3652",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "8333 E Blue Pkwy",
"address_purpose": "LOCATION",
"city": "Kansas City",
"state": "MO",
"postal_code": "641334750",
"country_code": "US",
"telephone_number": "816-474-7677",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WAGNER",
"first_name": "MICHELLE",
"middle_name": "V",
"credential": "LPC, LCPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-14",
"last_updated": "2026-08-12",
"certification_date": "2026-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "KS",
"license": "04107",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2022049325",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MICHELLE",
"last_name": "WATERMAN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Raytown, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.