MR. MATTHEW WAGNER LPC CAADC NPI 1053749168

NPI Information

NPI: 1053749168
Provider Name: MR. MATTHEW WAGNER, LPC, CAADC
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
545 N MCDONOUGH ST STE 212
DECATUR, GA
ZIP 30030
Phone: (770) 766-8128
Get Directions

MR. Matthew Wagner, LPC, CAADC is a professional counselor in Decatur, GA. MR. Matthew Wagner, LPC, CAADC NPI is 1053749168. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

545 N MCDONOUGH ST STE 212
DECATUR, GA
ZIP 30030-310
Phone: (770) 766-8128

The enumeration date for this NPI number is 10/29/2013 and was last updated on 11/1/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	C0212	GEORGIA	No
2	101YP2500X	Counselor	Professional	9583	GEORGIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »