Active NPI
Dean Wagenbrenner, LAPC
- Professional Counselor
- Atlanta, GA
National Provider Identifier
1639574767
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- APC003126
- Practice address
- 690 Courtenay Dr NE
Atlanta, GA 30306-3421 - Phone
- (404) 875-4551
- NPI assigned
- Oct 31, 2014
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | APC003126 | GA | Primary |
Addresses
Primary practice location
690 Courtenay Dr NE
Atlanta, GA 30306-3421
Mailing address
690 Courtenay Dr NE
Atlanta, GA 30306-3421
Phone (404) 875-4551
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 |
|---|---|---|---|
| APC003126 | GA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1414713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414713600000",
"number": "1639574767",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "690 COURTENAY DR NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303063421",
"telephone_number": "404-875-4551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "690 COURTENAY DR NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303063421",
"telephone_number": "404-875-4551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGENBRENNER",
"first_name": "DEAN",
"name_prefix": "Mr.",
"credential": "LAPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-10-31",
"last_updated": "2014-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "APC003126",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.