| Jonathan Eric Wagner, LPCC | |
|
2270 Ford Pkwy Ste 106, Saint Paul, MN 55116-3412 | |
| (612) 915-0049 | |
| Not Available |
| Full Name | Jonathan Eric Wagner |
|---|---|
| Gender | Male |
| Speciality | Mental Health Counselor |
| Experience | 12 Years |
| Location | 2270 Ford Pkwy Ste 106, Saint Paul, Minnesota |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063006724 | NPI | - | NPPES |
| 02291 | Other | MN | STATE OF MINNESOTA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 02291 (Minnesota) | Secondary |
| 101YP2500X | Counselor - Professional | 4525 (Minnesota) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Family Innovations Inc | 6204178528 | 57 |
| Entity Name | Family Innovations Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1992862783 PECOS PAC ID: 6204178528 Enrollment ID: O20190506002814 |
| Mailing Address | Practice Location Address |
|---|---|
| Jonathan Eric Wagner, LPCC 2270 Ford Pkwy Ste 106, Saint Paul, MN 55116-3412 Ph: (612) 915-0049 | Jonathan Eric Wagner, LPCC 2270 Ford Pkwy Ste 106, Saint Paul, MN 55116-3412 Ph: (612) 915-0049 |
Amber Langford, M.S. Counselor Medicare: Not Enrolled in Medicare Practice Location: 3250 Rice St, Saint Paul, MN 55126 Phone: 651-272-6229 | |
Yvette Anderson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 762 Transfer Rd Ste 21, Saint Paul, MN 55114 Phone: 218-355-8978 | |
Miss Kelly Pertzsch, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 2265 Como Ave, Saint Paul, MN 55108 Phone: 651-645-5325 Fax: 651-379-6141 | |
Abigail Brown, MA, LADC Counselor Medicare: Medicare Enrolled Practice Location: 1246 University Ave W, Saint Paul, MN 55104 Phone: 651-404-2000 | |
Pang Xiong, Counselor Medicare: Not Enrolled in Medicare Practice Location: 451 Lexington Pkwy N, Saint Paul, MN 55104 Phone: 651-280-2310 Fax: 651-280-3995 | |
Ms. Elizabeth Subramaniam, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 658 Grand Ave, Saint Paul, MN 55105 Phone: 612-920-2030 | |
Kyle Lipinski, MSS, LADC Counselor Medicare: Medicare Enrolled Practice Location: 438 Dorothy Day Pl, Saint Paul, MN 55102 Phone: 651-793-2219 |