Marilyn M Wagner, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

553 Issued in KY

Practice address

7511 New Lagrange Rd
Louisville, KY 40222-4859

Phone

(502) 423-1151

Fax

(502) 423-1748

NPI assigned

Aug 18, 2005

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Edelson and Associates, Inc.

  • Clinical Neuropsychologist
  • Louisville, KY
  • NPI 1952466468
  NPD (past)
• J Bennett Group PSC

  • Clinical Neuropsychologist
  • Louisville, KY
  • NPI 1790955334
  NPD (past)
• Optum Behavioral Care of North Carolina, P.C.

  • Clinical Social Worker
  • Gulfport, MS
  • NPI 1861371718
  NPD (past)

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1598757213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7511 NEW LAGRANGE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224859",
            "telephone_number": "502-423-1151",
            "fax_number": "502-423-1748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7511 NEW LAGRANGE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224859",
            "telephone_number": "502-423-1151",
            "fax_number": "502-423-1748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "MARILYN",
        "middle_name": "M",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-18",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "KY",
            "license": "553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89007553",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jake Wagner
• Jessica Ann Wagner, RPH, PHARMD, BCPS
• Joseph Lawrence Wagner III, DMD
• Laura McCauley Wagner, LMFT
• Logan Joseph Wagner
• Mary Isabel Wagner
• Paige Nicole Wagner, PHARM D
• Patrick Joseph Wagner, LCSW
• Paula Anne-Marie Wagner, PT
• Shaina Wagner

• Clinical Neuropsychologist in Louisville, KY
• Providers in Louisville, KY by specialty
• Clinical Neuropsychologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.

Verify at the official NPI Registry.