Wagener Therapy PLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

WAGENER THERAPY PLC

Practice address

6119 Deere Creek LN
Davenport, IA 52807-3402

Phone

(224) 216-4209

NPI assigned

Nov 23, 2021

Organization subpart

No

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

Authorized official

Name

Brandal J Wagener, LMHCNPI 1760038475

Title

Owner

Phone

(224) 216-4209

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brandal J Wagener, LMHC

  • Mental Health Counselor
  • Davenport, IA
  • NPI 1760038475
  NPD Authorized official

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

{
    "created_epoch": "1637625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683504000000",
    "number": "1750048898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4620 E 53RD ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073620",
            "telephone_number": "224-216-4209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6119 DEERE CREEK LN",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073402",
            "telephone_number": "224-216-4209"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4620 E 53rd St",
            "address_purpose": "LOCATION",
            "city": "Davenport",
            "state": "IA",
            "postal_code": "528073620",
            "country_code": "US",
            "telephone_number": "224-216-4209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WAGENER THERAPY PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-23",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A",
        "authorized_official_last_name": "WAGENER",
        "authorized_official_first_name": "BRANDAL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "224-216-4209",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "1760038475",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cara Marie Voelliger, DNP
• Margaret Olin Meloy Voelliger, LMSW
• Ilya B Volfson, MD
• John J. (Io) Von Arb, D.D.S.
• Elizabeth Vondera
• Brandal J Wagener, LMHC
• Sarah Wagener, T-LMHC
• Denise Jean Wagner, PHARMD
• Lisa Wagner
• Rebecca Wagschal, ARNP, CNM

• Mental Health Counselor in Davenport, IA
• Providers in Davenport, IA by specialty
• Mental Health Counselor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; 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.