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

Mr. Gerald Wagner Jr., LADC

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1962759084

Mr. Gerald Wagner Jr., LADC is an Addiction (Substance Use Disorder) Counselor in New London, Connecticut. Licensed in Connecticut. Registered with an NPI since 2012.

Licensed in
CT
In the registry since
2012
What do these letters mean?
LADC — Licensed Alcohol and Drug Counselor
A licensed addiction counsellor.

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Practice location Address checks out

21 Montauk Ave
New London, CT 06320-4906
Phone: (860) 271-4715
Fax: (860) 271-4797
Show map & directions

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

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 000326 (CT)

Record details

NPI number1962759084
Entity typeIndividual (Type 1)
GenderMale
Credentials LADC
Sole proprietorNo
NPI enumeratedAugust 8, 2012
Last updated in NPPESDecember 21, 2016

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