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MR. GERALD WAGNER JR. LADC
NPI 1962759084
Counselor - Addiction (Substance Use Disorder) in New London, CT

Active since August 08, 2012
21 MONTAUK AVE, NEW LONDON, CT 06320(860) 271-4715(860) 271-4797 Get Directions Write a Review

NPPES record last updated: December 21, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Gerald Wagner Jr. Ladc NPPES

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

MR. GERALD WAGNER JR. LADC (NPI 1962759084) is an individual addiction (substance use disorder) provider in New London, Connecticut, licensed in Connecticut (000326) and active in the NPI registry since August 2012.

NPPES Registry Identity

NPI1962759084
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameMR. GERALD WAGNER JR.Credential: LADC
Location Address21 MONTAUK AVENew London, CT 06320-4906
Mailing AddressPo Box 390New London, CT 06320-0390 · (860) 271-4715 · Fax (860) 271-4797
Phone(860) 271-4715
Fax(860) 271-4797
Sole ProprietorNo
Enumeration DateAugust 8, 2012
Last NPPES UpdateDecember 21, 2016
✔ NPI 1962759084 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in CT · 000326
21 MONTAUK AVE, New London, CT 06320
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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.

JODI SAMMARTINO LCSW
Social Worker (Clinical)
21 MONTAUK AVE
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 439-6400
CHERYL COTE M.S.W.
Social Worker (Clinical)
21 MONTAUK AVE
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 271-4700
MARGARET H CORNELL APRN
Clinical Nurse Specialist (Psychiatric/Mental Health, Geropsychiatric)
21 MONTAUK AVE
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 271-4700
BETHANY GALLANT LPC
Counselor (Professional)
21 MONTAUK AVE
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 443-0530
KATHLEEN GREGA LCSW
Social Worker (Clinical)
21 MONTAUK AVE
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 439-6400
CHRYSTAL ALINE CANOVA LCSW
Social Worker (Clinical)
21 MONTAUK AVE
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 439-6400
SARAH BOCHET
Social Worker (Clinical)
21 MONTAUK AVE
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 439-4700
DR. AMAN SYED DDS
Dentist (General Practice)
21 MONTAUK AVE, SUITE 102
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 447-9280

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 Gerald Wagner's NPI number?

The NPI number for Gerald Wagner is 1962759084. It was assigned to this individual provider in the NPPES registry on August 8, 2012.

Where is Gerald Wagner located?

Gerald Wagner practices at 21 Montauk Ave, New London, CT 06320. The listed phone number is (860) 271-4715.

What is Gerald Wagner's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Gerald Wagner was last updated on December 21, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.