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Organization
WAGNER AND ASSOCIATES MENTAL HEALTH SERVICES LLC
Active
Organization
WAGNER AND ASSOCIATES MENTAL HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHYLLISS WAGNER LPCC (OWNER)
(440) 296-2050
Entity
Organization
Contact information
Practice address
842 CORPORATE WAY STE 850, WESTLAKE, OH 44145-1537
(440) 296-2050
Mailing address
107 WOODSTOCK DR, AVON LAKE, OH 44012-1622
(440) 296-2050
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E.2001993
OH LICENSE
OH
Enumeration date
01/10/2021
Last updated
09/25/2024
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