Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Larry D Wagoner, PHD, LMFT

Individual provider Marriage & Family Therapist · NPI 1417046699

Dr. Larry D Wagoner, PHD, LMFT is a Marriage & Family Therapist in Jacksonville, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2006
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.
LMFT — Licensed Marriage and Family Therapist
A therapist licensed to treat couples and families.

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Practice location Address checks out

7545 Centurion Pkwy Ste # 105
Jacksonville, FL 32256-0579
Phone: (904) 642-2468
Fax: (904) 642-2469
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Marriage & Family Therapist (primary) Taxonomy 106H00000X · Licence MT1162 (FL)

Record details

NPI number1417046699
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD , LMFT
Sole proprietorYes
NPI enumeratedOctober 12, 2006
Last updated in NPPESJanuary 29, 2013

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