| Jennifer Wagner, LPC, LCDC | |
|
702 Holly St, Atlanta, TX 75551-2308 | |
| (903) 278-7795 | |
| Not Available |
| Full Name | Jennifer Wagner |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 702 Holly St, Atlanta, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508392135 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 13846 (Texas) | Secondary |
| 101YP2500X | Counselor - Professional | 78248 (Texas) | Primary |
| Entity Name | Sabine Valley Regional Mhmr Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1639232002 PECOS PAC ID: 0143202580 Enrollment ID: O20040601001132 |
| Entity Name | Mental Health Specialty Group Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801472634 PECOS PAC ID: 8921466228 Enrollment ID: O20240717000568 |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer Wagner, LPC, LCDC Po Box 777, Atlanta, TX 75551-0777 Ph: () - | Jennifer Wagner, LPC, LCDC 702 Holly St, Atlanta, TX 75551-2308 Ph: (903) 278-7795 |
Kelly Evans Joslin, MED., L.P.C. Counselor Medicare: Medicare Enrolled Practice Location: 604 W Main St, Atlanta, TX 75551 Phone: 903-796-0776 Fax: 903-799-9776 | |
Angela Michelle Matlock, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 444 Pr 332, Atlanta, TX 75551 Phone: 903-799-0551 | |
Mrs. Rosharon Shunta Turner, LPC Counselor Medicare: Medicare Enrolled Practice Location: 1011 S William St, Atlanta, TX 75551 Phone: 903-796-2868 Fax: 903-796-0826 | |
Mrs. Deborah James, LCDC, LPC Counselor Medicare: Medicare Enrolled Practice Location: 1011 S William St, Atlanta, TX 75551 Phone: 903-796-2868 | |
Dwayne Wayman Kilgore, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1008 N Louise St, Atlanta, TX 75551 Phone: 903-796-7155 | |
Mrs. Jennifer Sellers, LPC Counselor Medicare: Medicare Enrolled Practice Location: 1011 S William St, Atlanta, TX 75551 Phone: 903-796-2868 |