ELIZABETH WAGNER (LCPC ATR-BC) – Counselor, NPI 1306062922

ELIZABETH WAGNER (LCPC ATR-BC) is a healthcare provider. based in Champaign, Illinois. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LCPC ATR-BC. They hold a License No. 180.003668 (IL). The NPI Number for ELIZABETH WAGNER (LCPC ATR-BC) is 1306062922

Main info

Female
Sole Proprietor
32 Years Of Experience
Accepts Medicare Assignment
Name
ELIZABETH WAGNER (LCPC ATR-BC)
NPI
1306062922
Phone
(217) 398-8090
Address
105 N FAIR ST
Enumeration Date
18 April 2007
Last Update Date
18 November 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2173261330
Graduation Year
1994 (32 years ago)
PAC ID
7618312877
Group Practice PAC ID
3577515774
Professional Enrollment ID
I20240227002621
Address ID
IL618215923CH1802XAVEX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience72
Completeness85
Years active:19State licenses:1Digital endpointsOther names

2,307 MENTAL HEALTH COUNSELOR in IL

Provider Addresses for ELIZABETH WAGNER (LCPC ATR-BC)

  • 105 N FAIR ST

    CHAMPAIGN, IL 618213130

    Phone: (217) 398-8090

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-02-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240227002621IMental Health CounselorILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 61821)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3577515774View full group profile
NameSpecialtyState
G A S T R O E N T E R O L O G YIL
Nurse PractitionerIL
Clinical PsychologistIL
-FL
Nurse PractitionerIL
Gastroenterology, Internal MedicineWI
P O D I A T R YIL
Hospitalist, Family PracticeTX
Diagnostic RadiologyNY
-IL

Reviews

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Frequently asked questions

How do payers reference ELIZABETH WAGNER (LCPC ATR-BC)?
For ELIZABETH WAGNER (LCPC ATR-BC), use NPI 1306062922 as the unique 10-digit identifier.
Is there an active status for ELIZABETH WAGNER (LCPC ATR-BC)?
For scheduling context, ELIZABETH WAGNER (LCPC ATR-BC) is shown as active in the registry.
What area of care is associated with ELIZABETH WAGNER (LCPC ATR-BC)?
ELIZABETH WAGNER (LCPC ATR-BC)'s record emphasizes Counselor. Clinical services aligned with this taxonomy classification.
What locale is associated with ELIZABETH WAGNER (LCPC ATR-BC)?
Directory geography for ELIZABETH WAGNER (LCPC ATR-BC) centers on Champaign, Illinois.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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