REBECCA WAGNER PH.D. NPI 1407900632

NPI Information

  • NPI: 1407900632
  • Provider Name: REBECCA WAGNER, PH.D.
  • Classification: Psychologist - 103TC0700X
  • Specialization: Clinical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1259 LAKE PLAZA DR STE 255
    COLORADO SPRINGS, CO
    ZIP 80906
  • Phone: (719) 598-3585

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NPI Details

Rebecca Wagner, PH.D. is a clinical psychologist in Colorado Springs, CO. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. Rebecca Wagner, PH.D. NPI is 1407900632. 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:

1259 LAKE PLAZA DR STE 255
COLORADO SPRINGS, CO
ZIP 80906-504
Phone: (719) 598-3585

The NPI 1407900632 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS).

The enumeration date for this NPI number is 1/23/2007 and was last updated on 7/10/2023.

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
1103G00000XClinical Neuropsychologist1139SOUTH CAROLINANo
2103TC0700XPsychologistClinicalPSY.0005316COLORADOYes

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
1PS0478MEDICAIDSOUTH CAROLINA

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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