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

Dr. Melissa Chanell Wagner, PHD

Individual provider Psychologist · NPI 1891576021

Dr. Melissa Chanell Wagner, PHD is a Clinical Psychologist in Phoenix, Arizona. Qualified in 2016, 10 years ago. Practices with Banner - University Physician Specialists LLC, a 347-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Arizona.

Years since qualifying
10
Licensed in
AZ
In the registry since
2023
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

1111 E McDowell Rd
Phoenix, AZ 85006-2612
Phone: (480) 241-8122
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X · Licence PSY-005630 (AZ)

Record details

NPI number1891576021
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHD
Sole proprietorNo
NPI enumeratedOctober 12, 2023
Last updated in NPPESOctober 12, 2023
Certification dateOctober 12, 2023
Mailing address3929 S Nebraska St, Chandler, AZ 85248-4571

Medicare enrollment

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

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Banner - University Physician Specialists Llc — 347 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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