BENTON WAGNER NPI 1346668852

NPI Information

NPI: 1346668852
Provider Name: BENTON WAGNER
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
418 N RIVER ST
HAILEY, ID
ZIP 83333
Phone: (612) 247-9768
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Benton Wagner is a professional counselor in Hailey, ID. Benton Wagner NPI is 1346668852. 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:

418 N RIVER ST
HAILEY, ID
ZIP 83333-513
Phone: (612) 247-9768

The enumeration date for this NPI number is 4/1/2014 and was last updated on 9/27/2021.

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	LCPC-6760	IDAHO	No
2	101YP2500X	Counselor	Professional	LCPC-6760	IDAHO	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: 11/14/2023

NPI Synchronization or Removal

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