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Dr. Blake Douglas Wagner JR., PHD
Psychologist in Mansfield, Ohio
NPI 1013069061

Blake Douglas Wagner JR. is a Psychologist based in Mansfield, OH. Blake Douglas Wagner JR. practices in Mansfield, OH and has the professional credentials of PHD. The NPI Number for Blake Douglas Wagner JR. is 1013069061 and holds a License No. I-4127 (Ohio).

The current practice location address for Blake Douglas Wagner JR. is 1575 Marion Ave, Mansfield, OH and can be reached out via phone at 419-529-9941 and via fax at 419-529-0496.

Location: 1575 Marion Ave, Mansfield, OH, 44906-3409
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1013069061
Provider Name
Blake Douglas Wagner JR.
Credential
PHD
Provider Entity Type
Individual
Gender
Male
Address
1575 Marion Ave, Mansfield, OH, 44906-3409
Phone Number
419-529-9941
Fax Number
419-529-0496
Provider Enumeration Date
01/18/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000000315185 01 ANTHEM
institution
Provider Business Practice Location Address Details
Address
1575 Marion Ave
City
Mansfield
State
Ohio
Zip
44906-3409
Phone Number
419-529-9941
Fax Number
419-529-0496
person
Provider Business Mailing Address Details
Address
1575 Marion Ave
City
Mansfield
State
Ohio
Zip
44906-3409
Phone Number
419-529-9941
Fax Number
419-529-0496
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Psychologist
Speciality
-
Taxonomy
103T00000X
License No.
I-4127 (Ohio)
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
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