NICOLE S. WAGNER, PH.D., LLC – Clinical Psychologist, NPI 1053589135

NICOLE S. WAGNER, PH.D., LLC is a healthcare provider. based in Lakewood, Ohio. specializing in Clinical Psychologist. The organization holds a License No. 6025 (OH). The NPI Number for NICOLE S. WAGNER, PH.D., LLC is 1053589135

Main info

Organization
Name
NICOLE S. WAGNER, PH.D., LLC
NPI
1053589135
Phone
(216) 548-5469
Address
11740 CLIFTON BLVD
Authorized Official
DR. NICOLE S WAGNER MANAGING PARTNER PH.D.
Enumeration Date
12 February 2008
Last Update Date
12 February 2008
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:18State licenses:1Digital endpointsOther names

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Provider Addresses for NICOLE S. WAGNER, PH.D., LLC

  • 11740, Clifton Boulevard, Gold Coast, Edgewater, Lakewood, Cuyahoga County, Ohio, 44107, United States

    SUITE 202

    LAKEWOOD, OH 441072057

    Phone: (216) 548-5469

    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.

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Medicare Enrollment & Revalidation

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

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

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

Insurance plans in this area (ZIP 44107)

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Frequently asked questions

What NPI should I save for NICOLE S. WAGNER, PH.D., LLC?
Save NPI 1053589135 if you need a stable reference for NICOLE S. WAGNER, PH.D., LLC.
Is NICOLE S. WAGNER, PH.D., LLC's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What kind of provider is NICOLE S. WAGNER, PH.D., LLC?
The page reflects Clinical Psychologist for NICOLE S. WAGNER, PH.D., LLC. Clinical services aligned with this taxonomy classification.
Where is NICOLE S. WAGNER, PH.D., LLC's primary listing?
We display Lakewood, Ohio because that is what the record indicates for NICOLE S. WAGNER, PH.D., LLC.
Is NICOLE S. WAGNER, PH.D., LLC a real provider?
This page reflects official NPPES data for NPI 1053589135. Always confirm identity and privileges with the practice and licensing boards.

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