Phyliss Wagner, LPCC | |
842 Corporate Way Ste 850, Westlake, OH 44145-1537 | |
(440) 296-2050 | |
Not Available |
Full Name | Phyliss Wagner |
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Gender | Female |
Speciality | Counselor - Addiction (substance Use Disorder) |
Location | 842 Corporate Way Ste 850, Westlake, Ohio |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1003325416 | NPI | - | NPPES |
CDCA.164771 | Other | OH | LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | E.2001993 (Ohio) | Secondary |
101YA0400X | Counselor - Addiction (substance Use Disorder) | CDCA.164771 (Ohio) | Primary |
Entity Name | Wagner And Associates Mental Health Services Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1215525712 PECOS PAC ID: 4082060710 Enrollment ID: O20231031003613 |
Mailing Address | Practice Location Address |
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Phyliss Wagner, LPCC 107 Woodstock Dr, Avon Lake, OH 44012-1622 Ph: (440) 989-4987 | Phyliss Wagner, LPCC 842 Corporate Way Ste 850, Westlake, OH 44145-1537 Ph: (440) 296-2050 |
Ms. Lydia Ann Gadd, LPCC S Counselor Medicare: Not Enrolled in Medicare Practice Location: 24500 Center Ridge Rd, # 100, Westlake, OH 44145 Phone: 440-899-1300 Fax: 440-899-0266 | |
Jacquelyn Casalina, Counselor Medicare: Not Enrolled in Medicare Practice Location: 24500 Center Ridge Rd Ste 395, Westlake, OH 44145 Phone: 440-455-9125 | |
Mrs. Courtney Perse, LPCC-S Counselor Medicare: Medicare Enrolled Practice Location: 24481 Detroit Rd, Westlake, OH 44145 Phone: 440-310-6361 | |
Elizabeth Gootee, Counselor Medicare: Not Enrolled in Medicare Practice Location: 24600 Detroit Rd Ste 265, Westlake, OH 44145 Phone: 440-742-1661 Fax: 949-437-2034 | |
Carol Ball, LPCC-S Counselor Medicare: Not Enrolled in Medicare Practice Location: 25000 Center Ridge Rd, Suite 6, Westlake, OH 44145 Phone: 440-892-7034 | |
Mr. Michael Paul Kearney, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 30400 Detroit Rd, Suite 306, Westlake, OH 44145 Phone: 440-779-7324 Fax: 440-617-1960 |