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DERRICK WAGONER LPCC
NPI 1033529813
Counselor - Mental Health in Glasgow, KY

Active since May 02, 2014PECOS EnrolledAccepts Medicare Assignment
104 REYNOLDS RD, GLASGOW, KY 42141(270) 678-4801(270) 678-3866 Get Directions Write a Review

NPPES record last updated: May 12, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 12, 2021, Mar 29, 2017 (2 updates tracked since 2017).

About Derrick Wagoner Lpcc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DERRICK WAGONER LPCC (NPI 1033529813) is an individual mental health provider in Glasgow, Kentucky, licensed in Kentucky (172294) and active in the NPI registry since May 2014. He is enrolled in Medicare PECOS, maintains 3 additional practice locations, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1033529813
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameDERRICK WAGONERCredential: LPCC
Location Address104 REYNOLDS RDGlasgow, KY 42141-1177
Mailing Address104 Reynolds RdGlasgow, KY 42141-1177 · (270) 678-4801 · Fax (270) 678-3866
Phone(270) 678-4801
Fax(270) 678-3866
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateMay 2, 2014
Last NPPES UpdateMay 12, 20212 updates tracked since enumeration
NPPES CertifiedMay 12, 2021
✔ NPI 1033529813 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in KY · 172294
Also ListedCounselor · ProfessionalTaxonomy 101YP2500X · License 1839 (KY)
104 REYNOLDS RD, Glasgow, KY 42141
Open in Google Maps ↗

Secondary Practice Locations 3

Location 11048 Ashley St Ste 201Bowling Green, KY 42103-2449 · Phone (270) 904-6567 · Fax (270) 904-6570
Location 21600 Scottsville Rd Ste 101Bowling Green, KY 42104-3217 · Phone (270) 904-6567
Location 31910 Lyda AveBowling Green, KY 42104-3326 · Phone (270) 904-6567

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Derrick Wagoner Lpcc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7517407810
PECOS Enrollment IDI20240913000574
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AMY BRICKLER LPCC
Counselor (Professional)
104 REYNOLDS RD
GLASGOW, KY 42141
Barren County (270) 678-4801
RACHAEL KEELING
Counselor (Mental Health)
104 REYNOLDS RD
GLASGOW, KY 42141
Barren County (270) 904-6567
MARCIE NICOLE CRAIN LCSW
Social Worker (Clinical)
104 REYNOLDS RD
GLASGOW, KY 42141
Barren County (270) 678-4801
SARAH BUNCH LPCC-S
Counselor (Professional)
104 REYNOLDS RD
GLASGOW, KY 42141
Barren County (270) 904-6567
CAROL MCCARTHY CSW
Social Worker (Clinical)
104 REYNOLDS RD
GLASGOW, KY 42141
Barren County (270) 904-6567
APRIL MARTIN LCSW
Social Worker (Clinical)
104 REYNOLDS RD
GLASGOW, KY 42141
Barren County (270) 678-4801
MR. GEORGE G ELLIOTT LMFT, LMHC
Marriage & Family Therapist
104 REYNOLDS RD
GLASGOW, KY 42141
Barren County (270) 678-4801
LISA M. WOLFINBARGER LPCC
Counselor (Mental Health)
104 REYNOLDS RD
GLASGOW, KY 42141
Barren County (270) 678-4801

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Derrick Wagoner's NPI number?

The NPI number for Derrick Wagoner is 1033529813. It was assigned to this individual provider in the NPPES registry on May 2, 2014.

Where is Derrick Wagoner located?

Derrick Wagoner practices at 104 Reynolds Rd, Glasgow, KY 42141. The listed phone number is (270) 678-4801.

What is Derrick Wagoner's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Derrick Wagoner enrolled in Medicare?

Yes. Derrick Wagoner is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Derrick Wagoner accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter of Tennessee and Providence Health Plan list Derrick Wagoner as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Derrick Wagoner was last updated on May 12, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.