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

Wagner Psychotherapy LLC

Organization Clinical Psychologist · NPI 1962179804

Wagner Psychotherapy LLC is a Clinical Psychologist in Fairfax, Virginia. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

8280 Willow Oaks Corporate Dr Ste 600 - #5752
Fairfax, VA 22031-4516
Phone: (703) 646-1518
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X

Record details

NPI number1962179804
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Diane Wagner — Owner · (703) 646-1518
NPI enumeratedAugust 27, 2021
Last updated in NPPESAugust 27, 2021
Certification dateAugust 27, 2021
Mailing address10911 Adare Dr, Fairfax, VA 22032-3105

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