ELIZABETH WAGNER LCPC ATR-BC
NPI 1306062922
Counselor in Champaign, IL

Active since April 18, 2007PECOS EnrolledAccepts Medicare Assignment
105 N FAIR ST, CHAMPAIGN, IL 61821(217) 398-8090 Get Directions Write a Review

NPPES record last updated: November 18, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 18, 2025, Nov 14, 2019, Aug 15, 2018 (3 updates tracked since 2018).

About Elizabeth Wagner Lcpc Atr-bc NPPES

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

ELIZABETH WAGNER LCPC ATR-BC (NPI 1306062922) is an individual counselor in Champaign, Illinois, licensed in Illinois (180.003668) and active in the NPI registry since April 2007. She is enrolled in Medicare PECOS and is a graduate of Other (1994).

NPPES Registry Identity

NPI1306062922
Entity TypeIndividualFemale
Primary Taxonomy101Y00000X
Provider Legal NameELIZABETH WAGNERCredential: LCPC ATR-BC
Location Address105 N FAIR STChampaign, IL 61821
Mailing Address105 N Fair StChampaign, IL 61821-3130 · (217) 398-8090
Sole ProprietorYes
Medical School CMSOtherGraduated 1994
Enumeration DateApril 18, 2007
Last NPPES UpdateNovember 18, 20253 updates tracked since enumeration
NPPES CertifiedNovember 18, 2025
NPI 1306062922 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
License Licensed in IL · 180.003668
Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Also ListedCounselor · ProfessionalTaxonomy 101YP2500X · License 180.003668 (IL)
105 N FAIR ST, Champaign, IL 61821

Other Names 1

Former Name (1)Elizabeth Pruiett

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

Elizabeth Wagner Lcpc Atr-bc 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 ID7618312877
PECOS Enrollment IDI20240227002621
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

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

Social Worker (Clinical)
105 N FAIR ST
CHAMPAIGN, IL 61821

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 Elizabeth Wagner's NPI number?

The NPI number for Elizabeth Wagner is 1306062922. It was assigned to this individual provider in the NPPES registry on April 18, 2007. The provider is also known as Elizabeth Pruiett.

Where is Elizabeth Wagner located?

Elizabeth Wagner practices at 105 N Fair St, Champaign, IL 61821. The listed phone number is (217) 398-8090.

What is Elizabeth Wagner's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Is Elizabeth Wagner enrolled in Medicare?

Yes. Elizabeth Wagner 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.

When was this NPI record last updated?

The NPPES record for Elizabeth Wagner was last updated on November 18, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.