NICOLE S. WAGNER, PH.D., LLC
NPI 1053589135
Psychologist - Clinical in Lakewood, OH

Q: What is Nicole S. Wagner, Ph.D., LLC's NPI number?

The NPI number for Nicole S. Wagner, Ph.D., LLC is 1053589135. It was assigned to this organization in the NPPES registry on February 12, 2008.

Q: What is Nicole S. Wagner, Ph.D., LLC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Active since February 12, 2008

11740 CLIFTON BLVD, SUITE 202, LAKEWOOD, OH 44107(216) 548-5469 Get Directions Write a Review

NPPES record last updated: February 12, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Nicole S. Wagner, Ph.d., Llc NPPES

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

NICOLE S. WAGNER, PH.D., LLC (NPI 1053589135) is a healthcare organization registered as a clinical in Lakewood, Ohio and active in the NPI registry since February 2008. The organization lists Nicole S Wagner, Managing Partner, as its authorized official.

NPPES Registry Identity

NPI1053589135

Entity TypeOrganization

Primary Taxonomy103TC0700X

Legal Business NameNICOLE S. WAGNER, PH.D., LLC

Location Address11740 CLIFTON BLVD, SUITE 202Lakewood, OH 44107-2057

Mailing Address11740 Clifton Blvd, Suite 202Lakewood, OH 44107-2057 · (216) 548-5469

Phone(216) 548-5469

Organization SubpartNo

Authorized OfficialNicole S WagnerManaging Partner · (216) 548-5469

Enumeration DateFebruary 12, 2008

✔ NPI 1053589135 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in OH · 6025

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

11740 CLIFTON BLVD, Lakewood, OH 44107

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Other Identifiers 1

Medicare PINNI9366201OH

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Nicole S. Wagner, Ph.D., LLC's NPI number?

The NPI number for Nicole S. Wagner, Ph.D., LLC is 1053589135. It was assigned to this organization in the NPPES registry on February 12, 2008.

Where is Nicole S. Wagner, Ph.D., LLC located?

Nicole S. Wagner, Ph.D., LLC is located at 11740 Clifton Blvd Suite 202, Lakewood, OH 44107. The listed phone number is (216) 548-5469.

What is Nicole S. Wagner, Ph.D., LLC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for Nicole S. Wagner, Ph.D., LLC was last updated on February 12, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.