Elisabeth P Wagner, in West Valley City, UT - Medicare Counselor Provider

Elisabeth P Wagner, is a medicare enrolled "Counselor - Mental Health" provider in West Valley City, Utah. Her current practice location is 3737 W 4100 S, West Valley City, Utah. You can reach out to her office (for appointments etc.) via phone at (888) 949-4864.

Elisabeth P Wagner is licensed to practice in Utah (license number 9443009-6004) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1760095152.

Contact Information

	Elisabeth P Wagner,
	3737 W 4100 S, West Valley City, UT 84120-5543
	(888) 949-4864
	(206) 901-2010

Map and Direction

Healthcare Provider's Profile

Full Name	Elisabeth P Wagner
Gender	Female
Speciality	Counselor - Mental Health
Location	3737 W 4100 S, West Valley City, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1760095152
Provider Enumeration Date: 08/26/2020
Last Update Date: 02/25/2025

Medicare PECOS Information:

PECOS PAC ID: 4486171097
Enrollment ID: I20250507002103

Medical Identifiers

Medical identifiers for Elisabeth P Wagner such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1760095152	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	(* (Not Available))	Secondary
104100000X	Social Worker	(* (Not Available))	Secondary
171M00000X	Case Manager/care Coordinator	(* (Not Available))	Secondary
101YM0800X	Counselor - Mental Health	9443009-6004 (Utah)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Elisabeth P Wagner allows following entities to bill medicare on her behalf.

Entity Name	Valley Mental Health Incorporated
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1275599797 PECOS PAC ID: 0042121196 Enrollment ID: O20031111000937

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Elisabeth P Wagner is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Elisabeth P Wagner, 3725 W 4100 S Ste 201, Salt Lake City, UT 84120-5411 Ph: () -	Elisabeth P Wagner, 3737 W 4100 S, West Valley City, UT 84120-5543 Ph: (888) 949-4864

Reviews and Comments

Counselor in West Valley City, UT

Alisa L Harmon, MA, ACMHC, NCC Counselor Medicare: Not Enrolled in Medicare Practice Location: Lds Family Services, 5698 Glen Eagle Drive, West Valley City, UT 84128 Phone: 801-969-4181
Blanca Guadalupe Thompson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 5698 W Glen Eagle Dr, West Valley City, UT 84128 Phone: 801-917-5457
Robert Ewing, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2655 S Lake Erie Dr, West Valley City, UT 84120 Phone: 952-913-9124
Isabel Medellin, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4621 Cape Ridge Ln, West Valley City, UT 84128 Phone: 801-706-0887
Jacqueline Katt, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2655 S Lake Erie Dr, West Valley City, UT 84120 Phone: 138-544-1490
Saimoa Sam Amosa, AA, AS, BA Counselor Medicare: Not Enrolled in Medicare Practice Location: 2880 W 3650 S, West Valley City, UT 84119 Phone: 801-943-4636
Kristine Jolley Lanier, CMHC Counselor Medicare: Medicare Enrolled Practice Location: 3280 West 3500 South, Suite E, West Valley City, UT 84119 Phone: 801-979-1351

Elisabeth P Wagner, - Medicare Counselor in West Valley City, UT