Wagner Counseling Pllc Samantha Wagner Sole Mbr

NPI #1407655509 in Rockford, Illinois

Provider Information

NPI Number: 1407655509
Entity Type: Organization
Organization Name: Wagner Counseling Pllc Samantha Wagner Sole Mbr
Primary Specialty: Social Worker
Enumeration Date: Mar 11, 2025
Last Updated: Mar 11, 2025

Practice Location

Address: 112 N 2ND ST
City: Rockford
State: Illinois
ZIP Code: 61107-4051
Phone: (608) 313-4655

Authorized Official

Name: PATTY NUNEZ
Title: CREDENTIALING SPECIALIST
Phone: (312) 439-2321

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X
Social Worker	104100000X	Primary

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