DR. LARRY D WAGONER PH.D., LMFT
NPI 1417046699
Marriage & Family Therapist in Jacksonville, FL

Q: What is the provider's specialty?

The provider's specialty is Marriage & Family Therapist with taxonomy code 106H00000X.

Active since October 12, 2006

7545 CENTURION PKWY, SUITE # 105, JACKSONVILLE, FL 32256(904) 642-2468(904) 642-2469 Get Directions Write a Review

NPPES record last updated: January 29, 2013. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Dr. Larry D Wagoner Ph.d., Lmft NPPES

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

DR. LARRY D WAGONER PH.D., LMFT (NPI 1417046699) is an individual marriage & family therapist in Jacksonville, Florida, licensed in Florida (MT1162) and active in the NPI registry since October 2006.

NPPES Registry Identity

NPI1417046699

Entity TypeIndividualMale

Primary Taxonomy106H00000X

Provider Legal NameDR. LARRY D WAGONERCredential: PH.D., LMFT

Location Address7545 CENTURION PKWY, SUITE # 105Jacksonville, FL 32256-0579

Mailing Address2058 Beach AveAtlantic Beach, FL 32233-5935 · (904) 372-7365 · Fax (904) 372-7365

Phone(904) 642-2468

Fax(904) 642-2469

Sole ProprietorYes

Enumeration DateOctober 12, 2006

Last NPPES UpdateJanuary 29, 2013

✔ NPI 1417046699 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

License✔ Licensed in FL · MT1162

Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

7545 CENTURION PKWY, Jacksonville, FL 32256

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