Active NPI
James L Wagner, LMHP
- Mental Health Counselor
- South Sioux City, NE
National Provider Identifier
1841464799
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 2311
- Practice address
- 402 W 19TH St
South Sioux City, NE 68776-2639 - Phone
- (402) 494-5265
- NPI assigned
- Apr 22, 2008
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 2311 | NE | Primary |
Addresses
Primary practice location
402 W 19TH St
South Sioux City, NE 68776-2639
Mailing address
PO Box 268
Dakota City, NE 68731-0268
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2311 | Medicaid | NE |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263254400000",
"number": "1841464799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 268",
"city": "DAKOTA CITY",
"state": "NE",
"postal_code": "687310268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "402 W 19TH ST",
"city": "SOUTH SIOUX CITY",
"state": "NE",
"postal_code": "687762639",
"telephone_number": "402-494-5265"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "JAMES",
"middle_name": "L",
"credential": "LMHP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-04-22",
"last_updated": "2010-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NE",
"license": "2311",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2311",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in South Sioux City, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.