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Dr. Blake Douglas Wagner JR.

Psychologist

1575 Marion Ave
Mansfield , Ohio 44906-3409

Write a Review Save Call QR Code

(419) 529-0496

Image

Dr. Blake Douglas Wagner JR.

Psychologist

1575 Marion Ave
Mansfield , Ohio 44906-3409

(419) 529-0496

Write a Review Save Call

Dr. Blake Douglas Wagner JR.

Psychologist

1575 Marion Ave
Mansfield , Ohio 44906-3409

(419) 529-0496 Call

Write a Review Save
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Location
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Dr. Blake Douglas Wagner JR.
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About

Features

Language(s) Spoken
English
Ethnic Identity
White / Caucasian

Specialties

  • Psychologist

Languages spoken

  • English

Location

1575 Marion Ave Mansfield , Ohio 44906-3409
Get Directions

First Address

  • Dr. Blake Douglas Wagner JR.
  • 1575 Marion Ave
  • Mansfield, OH
  • Zip : 44906-3409
  • Fax : (419) 529-0496
  • Phone : (419) 529-9941

Second Address

  • Dr. Blake Douglas Wagner JR.
  • 1575 Marion Ave
  • Mansfield, OH
  • Zip : 44906-3409
  • Fax : (419) 529-0496
  • Phone : (419) 529-9941

Reviews

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FAQs

Where did Dr. Blake Douglas Wagner JR. attend graduate school?

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Where did Dr. Blake Douglas Wagner JR. do his residency?

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Where did Dr. Blake Douglas Wagner JR. do his fellowship?

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Is Dr. Blake Douglas Wagner JR. board certified?

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What type of doctor is Dr. Blake Douglas Wagner JR.

Psychologist

In what state does Dr. Blake Douglas Wagner JR. practice in?

Ohio

Where is Dr. Blake Douglas Wagner JR.’s practice located?

1575 Marion Ave , Mansfield, Ohio, 44906-3409

What is Dr. Blake Douglas Wagner JR.’s gender?

Male

Is Dr. Blake Douglas Wagner JR. a sole practitioner?

No

Is Dr. Blake Douglas Wagner JR. accepting new patients?

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What languages does Dr. Blake Douglas Wagner JR. speak?

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Does Dr. Blake Douglas Wagner JR. accept insurance?

Yes, Dr. Blake Douglas Wagner JR. accepts insurance

Does Dr. Blake Douglas Wagner JR. offers telemedicine?

Dr. Blake Douglas Wagner JR. has not indicated if he offers telemedicine

What is Dr. Blake Douglas Wagner JR.’s professional license number?

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What is Dr. Blake Douglas Wagner JR.’s NPI number?

1013069061

Does Dr. Blake Douglas Wagner JR. have any license restrictions?

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Scope of Practice

Primary Taxonomy Code Taxonomy Specialty License Number License State
Y 102L00000X Psychologist I-4127 OH
Y 103T00000X Psychologist I-4127 OH

National Provider Identifier

NPI 1013069061
Provider Name Dr. Blake Douglas Wagner JR.
First Address Mansfield, OH 44906-3409
Second Address Mansfield, OH 44906-3409
Gender M
NPI Entity type Individual
Is Sole Proprietor No
Is Organization Subpart N/A
Enumeration Date 18/01/2007
Last Update Date 02/09/2008

Additional Identifiers

IDENTIFIER TYPE / CODE IDENTIFIER STATE
000000315185 ANTHEM (01)
R71967 (02)

NPI Footnotes

What is the National Provider Identifier (NPI)

The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address

The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address

The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code

The code describing the type of health care provider that is being assigned an NPI. The entity type codes are:
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?

Subparts are the components and separate physical locations of organization health care providers. Subpart examples include: Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name

The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.

Provider Enumeration Date

The date the provider was assigned a unique identifier (assigned an NPI)

Last Update Date

The date that a NPI record was last updated or changed

Primary Taxonomy Code

The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPls the license data is associated to the taxonomy code.

Authorized Official Name

The name of the person authorized to submit the PI application or to officially change data for a health care provider.

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