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Active NPI 1063006724 Individual Practitioner Male Practitioner

Jonathan Eric Wagner , LPCC

Counselor - Professional • Saint Paul, MN

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Jonathan Wagner, LPCC is a certified Counselor - Professional practicing in Saint Paul, MN. With approximately 12 years of clinical experience since completing medical education in 2014, Jonathan Wagner delivers high-quality medical care to the local community at 2270 FORD PKWY STE 106.

Jonathan Wagner is affiliated with Family Innovations Inc and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Practice Location & Contact Primary Location

Practice Address

2270 Ford Pkwy Ste 106

Saint Paul, MN 551163412

Telephone 6129150049

Medicare Profile & Education

Medical School

Other

Graduation Year

2014

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Saint Paul, MN

Established Specialist (10-20 Yrs)
Practitioner Clinical Experience
12 Yrs +0.8 yrs vs City Avg
City Avg: 11.2 Yrs
State Avg: 11.4 Yrs
Regional Practice Density
203 Specialists

Practicing in Saint Paul, MN (2422 Statewide)

Telehealth Adoption Rate
8.9% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Wagner (12 Years) 12 Yrs
Saint Paul Specialty Average (11.2 Years) 11.2 Yrs

Medical Specialties & State Licenses

CMS Verified: 2025-05-01
Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License MN 4525

Definition to come...

Counselor - Mental Health

NUCC Taxonomy Code: 101YM0800X

State License MN 02291

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID State Of Minnesota
02291 (MN)

Hospital & Practice Group Affiliations

Family Innovations Inc

360 Sherman St, Saint Paul, MN 551022564

Phone: 6517485019

Secondary Practice Locations

320 Annapolis St E

West St Paul, MN 551181604

Phone: 6512109549

Practice Associates & Co-Workers

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

18 Associated Practitioners
Connor Bolduc

Counselor - Professional

NPI 1093460180
Melissa Haldeman , PMHNP-BC

Nurse Practitioner - Psychiatric/Mental Health

NPI 1144092743

Psychiatric-Mental Health Nurse Practitioner (Board Certified)

Lindsay Noreen , LPCC

Counselor - Professional

NPI 1164993267

Licensed Professional Clinical Counselor

Dr. Jennifer Hammes , PsyD, LP

Psychologist - Clinical

NPI 1184178394

Doctor of Psychology (Psy.D.), Licensed Psychologist

Jacynte Denardo , LPCC

Counselor - Professional

NPI 1194479212

Licensed Professional Clinical Counselor

Ashley Brinkman , LPCC

Counselor - Professional

NPI 1225500937

Licensed Professional Clinical Counselor

Career & Practice History Timeline

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

9 Historical Events
📍
Updated Practice Location May 01, 2025

Registered at 2270 FORD PKWY STE 106, SAINT PAUL, MN 551163412 (Tel: 6129150049)

📍
Updated Business Mailing Address May 01, 2025

Registered at 2270 FORD PKWY STE 106, SAINT PAUL, MN 551163412 (Tel: 6129150049)

👤
Provider Name / Credentials Updated May 01, 2025

Recorded as JONATHAN WAGNER, LPCC

NPI Profile Active February 23, 2021

NPI status registered as active in NPPES database

📍
Updated Practice Location February 23, 2021

Registered at 320 ANNAPOLIS ST E, WEST ST PAUL, MN 551181604 (Tel: 6512109549)

📍
Updated Business Mailing Address February 23, 2021

Registered at 320 ANNAPOLIS ST E, WEST ST PAUL, MN 551181604 (Tel: 6512109549)

👤
Provider Name / Credentials Updated February 23, 2021

Recorded as JONATHAN WAGNER, MA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 23, 2021

Counselor (License #02291 in MN)

🟢
Initial NPI Registration & Enumeration February 23, 2021

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: 1063006724
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 23, 2021
Last Update: May 01, 2025
Sole Proprietor: Yes

Mailing Address

2270 Ford Pkwy Ste 106

Saint Paul, MN 551163412

Phone: 6129150049

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.