Tonya Lavon Wagoner, LGPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LC12354 Issued in MD

Practice address

6512 Ronald Rd Apt T1
Capitol Heights, MD 20743-4481

Phone

(202) 819-3316

NPI assigned

Sep 15, 2021

Sex

Female

Sole proprietor

Yes

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Specialty

Mental Health Counselor

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1631664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1982374583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4733 W BRADDOCK RD APT 101",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223114733",
            "telephone_number": "202-819-3316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6512 RONALD RD APT T1",
            "city": "CAPITOL HEIGHTS",
            "state": "MD",
            "postal_code": "207434481",
            "telephone_number": "202-819-3316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGONER",
        "first_name": "TONYA",
        "middle_name": "LAVON",
        "credential": "LGPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-15",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC12354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jose M Velasquez
• Village Academy of Maryland
• Dominick Vilsaint, DPT
• Ashley Void, PH.D. LGPC
• Jeffrey Voorhees
• Kawanis Walker, CNA
• Samara Kache Wallace
• Katrice Wallace'Redmond
• Steve Lorenzo Ward
• Alvoid Washington

• Mental Health Counselor in Capitol Heights, MD
• Providers in Capitol Heights, MD by specialty
• Mental Health Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.