Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MRS. NICOLE L WAGSTROM PCC
NPI 1790814937
Counselor - Professional in Xenia, OH

Active since March 05, 2007
2000 RED ROBIN DR N, XENIA, OH 45385(937) 718-3317 Get Directions Write a Review

NPPES record last updated: June 11, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mrs. Nicole L Wagstrom Pcc NPPES

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

MRS. NICOLE L WAGSTROM PCC (NPI 1790814937) is an individual professional provider in Xenia, Ohio, licensed in Ohio (8377) and active in the NPI registry since March 2007.

NPPES Registry Identity

NPI1790814937
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameMRS. NICOLE L WAGSTROMCredential: PCC
Location Address2000 RED ROBIN DR NXenia, OH 45385-9915
Mailing Address2000 Red Robin Dr NXenia, OH 45385-9915 · (937) 718-3317
Sole ProprietorNo
Enumeration DateMarch 5, 2007
Last NPPES UpdateJune 11, 2026
NPPES CertifiedJune 11, 2026
NPI 1790814937 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License Licensed in OH · 8377
2000 RED ROBIN DR N, Xenia, OH 45385

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 Nicole Wagstrom's NPI number?

The NPI number for Nicole Wagstrom is 1790814937. It was assigned to this individual provider in the NPPES registry on March 5, 2007.

Where is Nicole Wagstrom located?

Nicole Wagstrom practices at 2000 Red Robin Dr N, Xenia, OH 45385. The listed phone number is (937) 718-3317.

What is Nicole Wagstrom's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

When was this NPI record last updated?

The NPPES record for Nicole Wagstrom was last updated on June 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 57 days 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.