Marisa Wagner, IMFT in Wauseon, OH - Medicare Counselor Provider

Marisa Wagner, IMFT is a medicare enrolled "Counselor - Mental Health" provider in Wauseon, Ohio. Her current practice location is 9104 State Route 108, Wauseon, Ohio. You can reach out to her office (for appointments etc.) via phone at (419) 388-6663.

Marisa Wagner is licensed to practice in Ohio (license number F.2400426) 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 1336816271.

Contact Information

	Marisa Wagner, IMFT
	9104 State Route 108, Wauseon, OH 43567-9526
	(419) 388-6663
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Marisa Wagner
Gender	Female
Speciality	Counselor - Mental Health
Location	9104 State Route 108, Wauseon, Ohio
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1336816271
Provider Enumeration Date: 08/27/2021
Last Update Date: 05/30/2025

Medicare PECOS Information:

PECOS PAC ID: 9335678010
Enrollment ID: I20250124001674

Medical Identifiers

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

Identifier	Type	State	Issuer
1336816271	NPI	-	NPPES
M.2100239-TRNE	Other	OH	OHIO COUNSELOR, SOCIAL WORKER, AND MARRIAGE AND FAMILY THERAPY BOARD

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	M.2100239-TRNE (Ohio)	Secondary
101YM0800X	Counselor - Mental Health	F.2400426 (Ohio)	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. Marisa Wagner allows following entities to bill medicare on her behalf.

Entity Name	Shalom Ministries
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1366573552 PECOS PAC ID: 7911376033 Enrollment ID: O20221213001281

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. Marisa 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
Marisa Wagner, IMFT 9104 State Route 108, Wauseon, OH 43567-9526 Ph: (419) 388-6663	Marisa Wagner, IMFT 9104 State Route 108, Wauseon, OH 43567-9526 Ph: (419) 388-6663

Reviews and Comments

Counselor in Wauseon, OH

Emily Stockham, Counselor Medicare: Not Enrolled in Medicare Practice Location: 13850 County Road D, Wauseon, OH 43567 Phone: 567-454-0340
George Boykin Sr., Counselor Medicare: Not Enrolled in Medicare Practice Location: 3491 State Route 108, Wauseon, OH 43567 Phone: 419-335-5533
Lisette Schuette, Counselor Medicare: Not Enrolled in Medicare Practice Location: 259 W Elm St, Wauseon, OH 43567 Phone: 419-337-0130
Angie Ellen Burton, LISW Counselor Medicare: Not Enrolled in Medicare Practice Location: 7320 State Route 108 Ste A, Wauseon, OH 43567 Phone: 419-335-3732
Mrs. Betty Jane Tingley, LSW Counselor Medicare: Medicare Enrolled Practice Location: 7320 State Highway 108, Suite A, Wauseon, OH 43567 Phone: 419-335-3723 Fax: 419-335-3462
Sarah Domoe, IBCLC Counselor Medicare: Not Enrolled in Medicare Practice Location: 715 Pine St, Wauseon, OH 43567 Phone: 419-345-0902

Marisa Wagner, IMFT - Medicare Counselor in Wauseon, OH