Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Wagner Medical PC

Organization Counselor · NPI 1225908981

Wagner Medical PC is a Counselor in Boston, Massachusetts. Registered with an NPI since 2025.

In the registry since
2025
Specialties on file
6
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

90 Canal St Ste 4
Boston, MA 02114-2022
Phone: (844) 843-7279
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X
Counselor Taxonomy 101Y00000X
Psychologist Taxonomy 103T00000X
Marriage & Family Therapist Taxonomy 106H00000X
Psychiatry Physician Taxonomy 2084P0800X
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X

Record details

NPI number1225908981
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tanya Roach — Chief Credentialing Admin Officer · (970) 329-7161
NPI enumeratedNovember 7, 2025
Last updated in NPPESNovember 7, 2025
Certification dateNovember 7, 2025
Mailing address1099 18th St Ste 2350, Denver, CO 80202-1936

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