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CORILYN ASHLEY WAGNER
NPI 1831028174
Counselor - Professional in Saint Paul, MN

Active since May 14, 2026PECOS Enrolled
1129 GRAND AVE, SAINT PAUL, MN 55105(612) 619-7611(651) 964-4748 Get Directions Write a Review

NPPES record last updated: May 14, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

About Corilyn Ashley Wagner NPPES

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

CORILYN ASHLEY WAGNER (NPI 1831028174) is an individual professional provider in Saint Paul, Minnesota, licensed in Minnesota (5588) and active in the NPI registry since May 2026. She is enrolled in Medicare PECOS and maintains a secondary practice location in Saint Paul.

NPPES Registry Identity

NPI1831028174
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameCORILYN ASHLEY WAGNER
Location Address1129 GRAND AVESaint Paul, MN 55105-2629
Mailing Address1129 Grand AveSaint Paul, MN 55105-2629 · (651) 641-0177 · Fax (651) 641-8635
Phone(612) 619-7611
Fax(651) 964-4748
Sole ProprietorYes
Enumeration DateMay 14, 2026
NPPES CertifiedMay 14, 2026
✔ NPI 1831028174 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 MN · 5588
1129 GRAND AVE, Saint Paul, MN 55105
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Secondary Practice Location 1

Location 11205 Grand AveSaint Paul, MN 55105-2634 · Phone (612) 619-7611 · Fax (651) 964-4748

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Corilyn Ashley Wagner is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 7

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

ANN MARGRETHE PEDERSEN SCHROEDER MSW
Social Worker (Clinical)
1129 GRAND AVE
SAINT PAUL, MN 55105
Ramsey County (651) 641-0177
ROBERTA ANN COLBY
Marriage & Family Therapist
1129 GRAND AVE
SAINT PAUL, MN 55105
Ramsey County (651) 268-3252
ALLISON CHANT LMFT
Marriage & Family Therapist
1129 GRAND AVE
SAINT PAUL, MN 55105
Ramsey County (651) 641-0177
MS. KATIE E. HECKMAN LMFT
Marriage & Family Therapist
1129 GRAND AVE
SAINT PAUL, MN 55105
Ramsey County (651) 641-0177
MS. LAURIE A KOCANDA
Counselor (Mental Health)
1129 GRAND AVE
SAINT PAUL, MN 55105
Ramsey County (651) 641-0177
ALLISON RICHARDS PHD, LP
Psychologist (Counseling)
1129 GRAND AVE
SAINT PAUL, MN 55105
Ramsey County (651) 444-5056
MRS. AMEE CHRISTINE CHRISTENSEN MA, LAMFT
Marriage & Family Therapist
1129 GRAND AVE
SAINT PAUL, MN 55105
Ramsey County (651) 444-5055

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 Corilyn Wagner's NPI number?

The NPI number for Corilyn Wagner is 1831028174. It was assigned to this individual provider in the NPPES registry on May 14, 2026.

Where is Corilyn Wagner located?

Corilyn Wagner practices at 1129 Grand Ave, Saint Paul, MN 55105. The listed phone number is (612) 619-7611.

What is Corilyn Wagner's specialty?

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

Is Corilyn Wagner enrolled in Medicare?

Yes. Corilyn Wagner is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Corilyn Wagner was last updated on May 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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.