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Active NPI 1073557229 Individual Practitioner Female Practitioner

Jamie R Wagner , LCPC, LPC, RPT-S

Counselor - Professional • Roscoe, IL

Professional Overview & Biography Verified Profile Summary

Jamie Wagner, LCPC, LPC, RPT-S is a registered healthcare professional specializing in Counselor - Professional in Roscoe, IL. Practice services are available at 11447 2ND ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

11447 2nd St
Suite 9b

Roscoe, IL 610739522

Telephone 8156014673
Fax 8663038062
Associated Practice Facility / Clinic
🏢 Maurie Steinley Pc Facility NPI 1801492673

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Roscoe, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 18.3 Yrs
State Avg: 17.0 Yrs
Regional Practice Density
17 Specialists

Practicing in Roscoe, IL (9683 Statewide)

Telehealth Adoption Rate
5.9% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-11-22
Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License IL 180033993

Definition to come...

Counselor - Mental Health

NUCC Taxonomy Code: 101YM0800X

State License WI 3206-125

Definition to come...

Counselor - Professional

NUCC Taxonomy Code: 101YP2500X

State License WI 3206-125

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
41000700 (WI)
Commercial Insurance / Payer ID Dean Insurance
14270 (WI)
Commercial Insurance / Payer ID Licenced Clin. Prof. Coun
180033993 (IL)
Commercial Insurance / Payer ID Lpc
3206-125 (WI)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

21 Associated Practitioners
Joseph Marella , LPC

Counselor - Mental Health

NPI 1063174381

Licensed Professional Counselor

NPI 1124639729
Karen Lakis , MS, NCC, CADC, LCPC

Counselor - Professional

NPI 1174096382

Master of Science, National Certified Counselor, Certified Alcohol and Drug Counselor, Licensed Clinical Professional Counselor

Suzanne Bates , LSW, CADC

Counselor - Addiction (Substance Use Disorder)

NPI 1225429327

Licensed Social Worker, Certified Alcohol and Drug Counselor

Kim Donovan , LCSW

Social Worker - Clinical

NPI 1225674674

Licensed Clinical Social Worker

Lynn Hamilton , LCPC

Counselor - Professional

NPI 1316573553

Licensed Clinical Professional Counselor

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Business Mailing Address November 01, 2023

Registered at 3705 TANGLEWOOD PL, JANESVILLE, WI 535467800 (Tel: 6082906705)

👤
Provider Name / Credentials Updated November 01, 2023

Recorded as JAMIE WAGNER, LCPC, LPC, RPT-S

NPI Profile Active September 14, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location September 14, 2015

Registered at 11447 2ND ST, SUITE 9B, ROSCOE, IL 610739522 (Tel: 8156014673)

📍
Updated Business Mailing Address September 14, 2015

Registered at 1748 GATEWAY BLVD, BELOIT, WI 535119801 (Tel: 6082906705)

👤
Provider Name / Credentials Updated September 14, 2015

Recorded as JAMIE WAGNER, LCPC, LPC, RPT

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 14, 2015

Counselor (License #3206-125 in WI)

🟢
Initial NPI Registration & Enumeration June 16, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1073557229
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 16, 2006
Last Update: November 22, 2023
Sole Proprietor: No

Mailing Address

3705 Tanglewood Pl

Janesville, WI 535467800

Phone: 6082906705

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.