PHYLISS WAGNER LPCC NPI 1003325416

NPI Information

NPI: 1003325416
Provider Name: PHYLISS WAGNER, LPCC
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

PECOS Registration: Yes

Address:
24500 CENTER RIDGE RD STE 110
WESTLAKE, OH
ZIP 44145
Phone: (440) 522-9810
Get Directions

Phyliss Wagner, LPCC is an addiction (substance use disorder) counselor in Westlake, OH. Phyliss Wagner, LPCC NPI is 1003325416. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

24500 CENTER RIDGE RD STE 110
WESTLAKE, OH
ZIP 44145-604
Phone: (440) 522-9810

The NPI 1003325416 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 9/28/2017 and was last updated on 12/8/2023.

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	101YP2500X	Counselor	Professional	E.2001993	OHIO	No
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)	CDCA.164771	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	CDCA.164771	OTHER	OHIO	LICENSE

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

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