Raymond Dale Wagoner, M.S., LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

P2310007 Issued in AR

Practice address

6815 Isaacs Orchard Rd
Springdale, AR 72762-6324

Phone

(479) 301-6227

NPI assigned

Jul 25, 2025

Sex

Male

Sole proprietor

No

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

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1753401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1740162056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3515 PASOFINO LOOP",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727641767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6815 ISAACS ORCHARD RD",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727626324",
            "telephone_number": "479-301-6227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGONER",
        "first_name": "RAYMOND",
        "middle_name": "DALE",
        "credential": "M.S., LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-25",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "P2310007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leigh Anna Wade, LCSW, RPT-S
• Kyle J Wages, PT, DPT
• Rex Dwayne Waggoner, CRNA
• Richard Waggoner
• Sameer Umakant Wagle, MD
• Joanna Wakefield, AUD CCC-A
• La'Troy Dante Wakefield, MHPP
• Wal-Mart Stores East LP
• Wal-Mart Stores, Inc.
• Wal-Mart Stores, Inc.

• Mental Health Counselor in Springdale, AR
• Providers in Springdale, AR by specialty
• Mental Health Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.