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MR. MATTHEW WAGNER LPC, CAADC
NPI 1053749168
Counselor - Professional in Decatur, GA

Active since October 29, 2013
545 N MCDONOUGH ST STE 212, DECATUR, GA 30030(770) 766-8128 Get Directions Write a Review

NPPES record last updated: November 1, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Matthew Wagner Lpc, Caadc NPPES

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

MR. MATTHEW WAGNER LPC, CAADC (NPI 1053749168) is an individual professional provider in Decatur, Georgia, licensed in Georgia (9583) and active in the NPI registry since October 2013.

NPPES Registry Identity

NPI1053749168
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameMR. MATTHEW WAGNERCredential: LPC, CAADC
Location Address545 N MCDONOUGH ST STE 212Decatur, GA 30030-3310
Mailing Address545 N Mcdonough St Ste 212Decatur, GA 30030-3310 · (770) 766-8128
Phone(770) 766-8128
Sole ProprietorYes
Enumeration DateOctober 29, 2013
Last NPPES UpdateNovember 1, 2018
✔ NPI 1053749168 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in GA · 9583
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License C0212 (GA)
545 N MCDONOUGH ST STE 212, Decatur, GA 30030
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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 Matthew Wagner's NPI number?

The NPI number for Matthew Wagner is 1053749168. It was assigned to this individual provider in the NPPES registry on October 29, 2013.

Where is Matthew Wagner located?

Matthew Wagner practices at 545 N Mcdonough St Ste 212, Decatur, GA 30030. The listed phone number is (770) 766-8128.

What is Matthew Wagner's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

When was this NPI record last updated?

The NPPES record for Matthew Wagner was last updated on November 1, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.