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

Dr. Blake Douglas Wagner Jr., PHD

Individual provider Psychologist · NPI 1013069061

Dr. Blake Douglas Wagner Jr., PHD is a Clinical Psychologist in Mansfield, Ohio. Qualified in 1988, 38 years ago. Practices with New Directions Eap Inc, a 3-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Ohio.

Years since qualifying
38
Licensed in
OH
In the registry since
2007
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

1575 Marion Ave
Mansfield, OH 44906-3409
Phone: (419) 529-9941
Fax: (419) 529-0496
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X · Licence I-4127 (OH)

Record details

NPI number1013069061
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorNo
NPI enumeratedJanuary 18, 2007
Last updated in NPPESSeptember 2, 2008

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 1988 (38 years in practice)
Group practice New Directions Eap Inc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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