Organization
MENTAL HEALTH MANAGED LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRITTAINY WAGNER LPC (COO)
(903) 267-4023
Entity
Organization
Contact information
Practice address
30 N GOULD ST STE 42472, SHERIDAN, WY 82801-6317
(903) 267-4023
(903) 487-0600
Mailing address
1431 W WOODARD ST, DENISON, TX 75020-3449
(903) 267-4023
(903) 487-0600
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
—
—
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
—
—
Other
Enumeration date
11/04/2024
Last updated
03/11/2025
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