Individual provider · Type 1 NPI
Jonathan Stewart Wagner, LPC-MHSP, NCC
Mental Health Counselor · Nampa, ID
NPI number
1679144836
Active
Practice location
2141 W Moose Creek Dr
Nampa, ID 83686-5185
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | 4117 (TN) |
Mental Health Counselor: Definition to come...
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About NPI 1679144836
Jonathan Stewart Wagner, LPC-MHSP, NCC's National Provider Identifier is 1679144836, issued on Jul 8, 2021. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Nampa, ID. The record was last updated on Jul 8, 2021.