KELLI WAGNER LPC
NPI 1306604343
Counselor - Mental Health in Goodyear, AZ
About Kelli Wagner Lpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELLI WAGNER LPC (NPI 1306604343) is an individual mental health provider in Goodyear, Arizona, licensed in Arizona (LPC-20244) and active in the NPI registry since March 2024. She has opted out of Medicare through January 15, 2028.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Kelli Wagner Lpc has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 15, 2024 through January 15, 2028.
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 Kelli Wagner's NPI number?
The NPI number for Kelli Wagner is 1306604343. It was assigned to this individual provider in the NPPES registry on March 12, 2024. The provider is also known as Kelli Carpenter.
Where is Kelli Wagner located?
Kelli Wagner practices at 15655 W Roosevelt St Ste 224, Goodyear, AZ 85338. The listed phone number is (928) 683-1720.
What is Kelli Wagner's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Kelli Wagner enrolled in Medicare?
No. Kelli Wagner has opted out of Medicare through January 15, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.
When was this NPI record last updated?
The NPPES record for Kelli Wagner was last updated on March 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Kelli Wagner, LPC · NPI 1306604343
Mental Health provider in Goodyear, Arizona. Individual provider, active in the CMS NPPES registry since March 12, 2024.
## Identity
- **NPI:** 1306604343 (Entity type: Individual)
- **Enumerated:** March 12, 2024
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **State license:** LPC-20244 (Arizona)
- **Sole proprietor:** No
## Practice location
- **Address:** 15655 W ROOSEVELT ST STE 224, Goodyear, AZ 85338-9306
- **Phone:** (928) 683-1720
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through January 15, 2028); services are provided under private contract
## Record status
- **NPPES last updated:** March 12, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1306604343) · Data from the CMS NPPES public registry.