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MR. BRANDAL J WAGENER LMHC
NPI 1760038475
Counselor - Mental Health in Davenport, IA

Active since August 18, 2019
4620 E 53RD ST STE 200, DAVENPORT, IA 52807(224) 216-4209 Get Directions Write a Review

NPPES record last updated: February 26, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 26, 2023, Aug 18, 2019 (2 updates tracked since 2019).

About Mr. Brandal J Wagener Lmhc NPPES

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

MR. BRANDAL J WAGENER LMHC (NPI 1760038475) is an individual mental health provider in Davenport, Iowa, licensed in Iowa (093843) and active in the NPI registry since August 2019.

NPPES Registry Identity

NPI1760038475
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameMR. BRANDAL J WAGENERCredential: LMHC
Location Address4620 E 53RD ST STE 200Davenport, IA 52807-3627
Mailing Address4620 E 53rd St Ste 200Davenport, IA 52807-3627 · (224) 216-4209
Phone(224) 216-4209
Sole ProprietorNo
Enumeration DateAugust 18, 2019
Last NPPES UpdateFebruary 26, 20232 updates tracked since enumeration
NPPES CertifiedFebruary 26, 2023
✔ NPI 1760038475 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in IA · 093843
4620 E 53RD ST STE 200, Davenport, IA 52807
Open in Google Maps ↗

Other Providers at the Same Location NPPES 8

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

MICHAEL ANTHONY COX LMHC
Counselor (Mental Health)
4620 E 53RD ST STE 200
DAVENPORT, IA 52807
Scott County (563) 484-0840
ZYN MEDICAL SUPPLY LLC
Durable Medical Equipment & Medical Supplies
4620 E 53RD ST STE 200
DAVENPORT, IA 52807
Scott County (815) 505-5884
MONOGRAM HEALTH PROFESSIONAL SERVICES OF IOWA PLLC
Internal Medicine (Nephrology)
4620 E 53RD ST STE 200
DAVENPORT, IA 52807
Scott County (615) 623-4455
SARAH WAGENER T-LMHC
Counselor (Mental Health)
4620 E 53RD ST STE 200
DAVENPORT, IA 52807
Scott County (563) 223-8118
KEZIA TYREE ANDRENETTE MCLEMORE RN
Registered Nurse (Medical-Surgical)
4620 E 53RD ST STE 200
DAVENPORT, IA 52807
Scott County (877) 523-6160
CHAMPIONS DEVELOPMENTAL CARE
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
4620 E 53RD ST STE 200
DAVENPORT, IA 52807
Scott County (563) 949-1148
AFFLUENCE CARE LLC
Home Health
4620 E 53RD ST STE 200
DAVENPORT, IA 52807
Scott County (563) 343-4176
MAIN STREET HEALTH PARTNERS, P.C.
Family Medicine
4620 E 53RD ST STE 200
DAVENPORT, IA 52807
Scott County (563) 293-7700

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 Brandal Wagener's NPI number?

The NPI number for Brandal Wagener is 1760038475. It was assigned to this individual provider in the NPPES registry on August 18, 2019.

Where is Brandal Wagener located?

Brandal Wagener practices at 4620 E 53rd St Ste 200, Davenport, IA 52807. The listed phone number is (224) 216-4209.

What is Brandal Wagener's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Brandal Wagener was last updated on February 26, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.