person
Phyliss Wagner, LPCC
Addiction (Substance Use Disorder) Counselor in Westlake, Ohio
NPI 1003325416

Phyliss Wagner is an Addiction (Substance Use Disorder) Counselor based in Avon Lake, OH and is specialized in Addiction (Substance Use Disorder). Phyliss Wagner practices in Westlake, OH and has the professional credentials of LPCC. The NPI Number for Phyliss Wagner is 1003325416 and holds a License No. E.2001993 (Ohio).

The current practice location address for Phyliss Wagner is 24500 Center Ridge Rd Ste 110, Westlake, OH and can be reached out via phone at 440-522-9810. You can also correspond with Phyliss Wagner through the mailing address at 107 WOODSTOCK DR, AVON LAKE, OH - 44012-1622 (mailing address contact number: 440-989-4987).

Location: 24500 Center Ridge Rd Ste 110, Westlake, OH, 44012-1622
person
Provider Profile Details
NPI Number
1003325416
Provider Name
Phyliss Wagner
Credential
LPCC
Provider Entity Type
Individual
Gender
Female
Address
24500 Center Ridge Rd Ste 110, Westlake, OH, 44012-1622
Phone Number
440-522-9810
Fax Number
Provider Enumeration Date
09/28/2017
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
CDCA.164771 01 OH LICENSE
institution
Provider Business Practice Location Address Details
Address
24500 Center Ridge Rd Ste 110
City
State
Zip
44145-5604
Phone Number
440-522-9810
Fax Number
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Provider Business Mailing Address Details
Address
107 Woodstock Dr
City
State
Zip
44012-1622
Phone Number
440-989-4987
Fax Number
440-296-2050
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
CDCA.164771 (Ohio)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
E.2001993 (Ohio)
Definition
Definition to come...
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