Active NPI
Heather Devault Wagner
- Professional Counselor
- Morrisville, NC
National Provider Identifier
1831369917
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 3550
- Practice address
- 3800 Paramount Pkwy
Suite 300
Morrisville, NC 27560-6949 - Phone
- (919) 674-2712
- Fax
- (919) 379-9039
- NPI assigned
- Mar 5, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 3550 | NC | Primary |
Addresses
Primary practice location
3800 Paramount Pkwy
Suite 300
Morrisville, NC 27560-6949
Mailing address
3800 Paramount Pkwy
Suite 300
Morrisville, NC 27560-6949
Phone (919) 674-2712
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 |
|---|---|---|---|
| 3550 | NC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204675200000",
"number": "1831369917",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3800 PARAMOUNT PKWY",
"address_2": "SUITE 300",
"city": "MORRISVILLE",
"state": "NC",
"postal_code": "275606949",
"telephone_number": "919-674-2712",
"fax_number": "919-379-9039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3800 PARAMOUNT PKWY",
"address_2": "SUITE 300",
"city": "MORRISVILLE",
"state": "NC",
"postal_code": "275606949",
"telephone_number": "919-674-2712",
"fax_number": "919-379-9039"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "HEATHER",
"middle_name": "DEVAULT",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-05",
"last_updated": "2008-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "3550",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Morrisville, NC
- Simone Venning, AGNP
- Vigilint Expeditionary Solutions
- Vigilint Protective Health Solutions, PLLC
- Vip Care Transportation LLC
- Wesley Jackson Wade, NCC, CCMHC, LCAS-A
- Derek Wahl, PA-C
- Wake Med Children'S PM Pediatric Urgent Care
- Wake Specialty Physicians
- Wake Specialty Physicians LLC
- Wake Specialty Physicians, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.