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Active NPI 1841660636 Individual Practitioner Male Practitioner

Kell Wagner , NCC, LPC ASSOCIATE

Counselor - Professional • Medford, OR

Professional Overview & Biography Verified Profile Summary

Kell Wagner, NCC, LPC ASSOCIATE is a registered healthcare professional specializing in Counselor - Professional in Medford, OR. Practice services are available at 1040 CRATER LAKE AVE STE D under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1040 Crater Lake Ave Ste D

Medford, OR 975046295

Telephone 5418407684
Associated Practice Facility / Clinic
🏢 Peace In Mind Counseling Facility NPI 1407493513

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Medford, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.1 Yrs
State Avg: 13.7 Yrs
Regional Practice Density
85 Specialists

Practicing in Medford, OR (2601 Statewide)

Telehealth Adoption Rate
3.5% 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: 2024-01-18
Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License OR C6938

Definition to come...

Practice Associates & Co-Workers

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

2 Associated Practitioners
Andrew Stuck

Counselor - Mental Health

NPI 1649678152
Raymond Shumway , LCSW

Social Worker - Clinical

NPI 1982884912

Licensed Clinical Social Worker

Career & Practice History Timeline

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

16 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 18, 2024

Counselor (License #C6938 in OR)

📍
Updated Practice Location September 23, 2021

Registered at 1040 CRATER LAKE AVE STE D, MEDFORD, OR 975046295 (Tel: 5418407684)

📍
Updated Business Mailing Address September 23, 2021

Registered at 1040 CRATER LAKE AVE STE D, MEDFORD, OR 975046295

👤
Provider Name / Credentials Updated September 23, 2021

Recorded as KELL WAGNER, NCC, LPC ASSOCIATE

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

Counselor (License #R4413 in OR)

✅
NPI Profile Active October 24, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location October 24, 2017

Registered at 711 E MAIN ST STE 12, MEDFORD, OR 975047139 (Tel: 5418407684)

📍
Updated Business Mailing Address October 24, 2017

Registered at 711 E MAIN ST STE 12, MEDFORD, OR 975047139

👤
Provider Name / Credentials Updated October 24, 2017

Recorded as KELL WAGNER, MS, NCC, LPC INTERN

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 24, 2017

Counselor

✅
NPI Profile Active September 08, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location September 08, 2016

Registered at 140 S HOLLY ST, MEDFORD, OR 975013113 (Tel: 5412687180)

📍
Updated Business Mailing Address September 08, 2016

Registered at 140 S HOLLY ST, MEDFORD, OR 975013113

👤
Provider Name / Credentials Updated September 08, 2016

Recorded as KELL WAGNER

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 08, 2016

Counselor

🟢
Initial NPI Registration & Enumeration October 06, 2015

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: 1841660636
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 06, 2015
Last Update: January 18, 2024
Sole Proprietor: Yes
Update or Correct Profile

Mailing Address

1040 Crater Lake Ave Ste D

Medford, OR 975046295

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.