KEVIN DWAYNE BAGWELL LPC NPI 1710010152

NPI Information

  • NPI: 1710010152
  • Provider Name: KEVIN DWAYNE BAGWELL, LPC
  • Classification: Counselor - 101YP2500X
  • Specialization: Professional
  • Entity Type: Individual
  • Address: 75 W HOLLY ST UNIT 3010
    PASADENA, CA
    ZIP 91103
  • Phone: (231) 633-3400

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NPI Details

Kevin Dwayne Bagwell, LPC is a professional counselor in Pasadena, CA. Kevin Dwayne Bagwell, LPC NPI is 1710010152. 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:

75 W HOLLY ST UNIT 3010
PASADENA, CA
ZIP 91103-309
Phone: (231) 633-3400

The enumeration date for this NPI number is 3/14/2007 and was last updated on 8/29/2025.

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
1101YM0800XCounselorMental Health17520CALIFORNIANo
2101YM0800XCounselorMental Health6401009233MICHIGANNo
3101YP2500XCounselorProfessional17520CALIFORNIAYes

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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