WYATT ALAN AGNEW MFT INTERN
NPI 1538751771
Marriage & Family Therapist in Mesa, AZ

Q: What is Wyatt Agnew's NPI number?

The NPI number for Wyatt Agnew is 1538751771. It was assigned to this individual provider in the NPPES registry on February 9, 2021.

Q: What is Wyatt Agnew's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Q: When was this NPI record last updated?

The NPPES record for Wyatt Agnew was last updated on February 9, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since February 09, 2021PECOS Enrolled

235 S EL DORADO CIR, MESA, AZ 85202(480) 968-2995 Get Directions Write a Review

NPPES record last updated: February 9, 2021. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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About Wyatt Alan Agnew Mft Intern NPPES

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

WYATT ALAN AGNEW MFT INTERN (NPI 1538751771) is an individual marriage & family therapist in Mesa, Arizona and active in the NPI registry since February 2021. He is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1538751771

Entity TypeIndividualMale

Primary Taxonomy106H00000X

Provider Legal NameWYATT ALAN AGNEWCredential: MFT INTERN

Location Address235 S EL DORADO CIRMesa, AZ 85202-1044

Mailing Address1800 W Elliot Rd Unit 203Chandler, AZ 85224-8831 · (480) 298-8799

Phone(480) 968-2995

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateFebruary 9, 2021

NPPES CertifiedFebruary 9, 2021

✔ NPI 1538751771 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

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.

235 S EL DORADO CIR, Mesa, AZ 85202

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Wyatt Alan Agnew Mft Intern is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID840769311

PECOS Enrollment IDI20260513003589

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 20

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

CROZIER RODNEY KIMBALL JR. LPC

Counselor (Professional)