person
Derrick Wagoner, LPCC
Mental Health Counselor in Glasgow, Kentucky
NPI 1033529813

Derrick Wagoner is a Mental Health Counselor based in Glasgow, KY and is specialized in Mental Health. Derrick Wagoner practices in Glasgow, KY and has the professional credentials of LPCC. The NPI Number for Derrick Wagoner is 1033529813 and holds a License No. 1839 (Kentucky).

The current practice location address for Derrick Wagoner is 104 Reynolds Rd, Glasgow, KY and can be reached out via phone at 270-678-4801 and via fax at 270-678-3866.

Location: 104 Reynolds Rd, Glasgow, KY, 42141-1177
person
Provider Profile Details
NPI Number
1033529813
Provider Name
Derrick Wagoner
Credential
LPCC
Provider Entity Type
Individual
Gender
Male
Address
104 Reynolds Rd, Glasgow, KY, 42141-1177
Phone Number
270-678-4801
Fax Number
270-678-3866
Provider Enumeration Date
05/02/2014
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
104 Reynolds Rd
City
State
Zip
42141-1177
Phone Number
270-678-4801
Fax Number
270-678-3866
person
Provider Business Mailing Address Details
Address
104 Reynolds Rd
City
State
Zip
42141-1177
Phone Number
270-678-4801
Fax Number
270-678-3866
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
172294 (Kentucky)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
1839 (Kentucky)
Definition
Definition to come...
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