MARISA WAGNER IMFT NPI 1336816271

NPI Information

NPI: 1336816271
Provider Name: MARISA WAGNER, IMFT
Classification: Counselor - 101YM0800X
Specialization: Mental Health
Entity Type: Individual
PECOS Registration: Yes
Address: 9104 STATE ROUTE 108
WAUSEON, OH
ZIP 43567
Phone: (419) 388-6663

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NPI Details

Marisa Wagner, IMFT is a mental health counselor in Wauseon, OH with 4 years of experience. Marisa Wagner, IMFT NPI is 1336816271. 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:

9104 STATE ROUTE 108
WAUSEON, OH
ZIP 43567-526
Phone: (419) 388-6663

The NPI 1336816271 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 8/27/2021 and was last updated on 5/30/2025.

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	101YM0800X	Counselor	Mental Health	M.2100239-TRNE	OHIO	No
2	101YM0800X	Counselor	Mental Health	F.2400426	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	M.2100239-TRNE	OTHER	OHIO	OHIO COUNSELOR, SOCIAL WORKER, AND MARRIAGE AND FAMILY THERAPY BOARD

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: 11/21/2025

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