Individual provider · Type 1 NPI

Benton Wagner

Mental Health Counselor · Hailey, ID

NPI number 1346668852 Active

Practice location

418 N River St
Hailey, ID 83333-8513

Call (612) 247-9768 Map

Mailing address

PO Box 424
Fairfield, ID 83327-0424

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XLCPC-6760 (ID)
Professional Counselor 101YP2500XLCPC-6760 (ID)

Mental Health Counselor: Definition to come...

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About NPI 1346668852

Benton Wagner's National Provider Identifier is 1346668852, issued on Apr 1, 2014. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Hailey, ID. The record was last updated on Sep 29, 2026.