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

Jason Fredrick Wagner, APRN, LMHC, MCAP

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1720536691

Jason Fredrick Wagner, APRN, LMHC, MCAP is a Nurse Practitioner in Hollywood, Florida. Qualified in 2019, 7 years ago. Practices with Seminole Tribe of Florida, an 8-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
7
Licensed in
FL
In the registry since
2016
Specialties on file
3
What do these letters mean?
APRN — Advanced Practice Registered Nurse
The umbrella licence covering nurse practitioners, midwives, anaesthetists and clinical nurse specialists.
LMHC — Licensed Mental Health Counselor
A licensed mental health counsellor; the title used in Florida, New York and Washington among others.

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Practice location Address checks out

111 W Coral Way
Hollywood, FL 33021-3860
Phone: (954) 964-6338
Fax: (954) 965-1327
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence APRN11004343 (FL)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence MH8961 (FL)
Mental Health Counselor Taxonomy 101YM0800X · Licence MH8961 (FL)

Record details

NPI number1720536691
Entity typeIndividual (Type 1)
GenderMale
Credentials APRN , LMHC , MCAP
Sole proprietorYes
NPI enumeratedSeptember 20, 2016
Last updated in NPPESMay 1, 2024
Certification dateMay 1, 2024

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Seminole Tribe Of Florida — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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