| John M Wagner, MS | |
|
580 Mohawk Dr, Boulder, CO 80303-3712 | |
| (303) 338-4545 | |
| Not Available |
| Full Name | John M Wagner |
|---|---|
| Gender | Male |
| Speciality | Marriage & Family Therapist |
| Location | 580 Mohawk Dr, Boulder, Colorado |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861802498 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | MFT.0001333 (Colorado) | Primary |
| 101YM0800X | Counselor - Mental Health | NLC.0103614 (Colorado) | Secondary |
| Entity Name | Colorado Permanente Medical Group Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760599724 PECOS PAC ID: 1254238454 Enrollment ID: O20031216000640 |
| Mailing Address | Practice Location Address |
|---|---|
| John M Wagner, MS 10350 E Dakota Ave, Denver, CO 80247-1314 Ph: () - | John M Wagner, MS 580 Mohawk Dr, Boulder, CO 80303-3712 Ph: (303) 338-4545 |
Coco Caporal, Couples Therapy Medicare: Medicare Enrolled Practice Location: 2975 Valmont Rd Ste 300, Boulder, CO 80301 Phone: 303-415-1025 | |
Ms. Miriam F Schiff, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 5412 Idylwild Trl, Suite 102, Boulder, CO 80301 Phone: 303-619-3744 | |
Trina Renee Brown, MFTI Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 2825 Marine St Ste 203, Boulder, CO 80303 Phone: 720-605-6605 | |
Kathleen Snow, MFTC Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 3434 47th St Ste 230, Boulder, CO 80301 Phone: 720-504-8489 | |
Katherine Hunt Austin Iv, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 2305 Canyon Blvd Ste 101, Boulder, CO 80302 Phone: 303-917-5418 | |
Desirae Parker, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 1333 Iris Ave, Boulder, CO 80304 Phone: 303-413-6329 | |
Benjamin Taylor Finlayson, PHD Couples Therapy Medicare: Medicare Enrolled Practice Location: 1790 30th St Ste 350, Boulder, CO 80301 Phone: 806-470-7533 |