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

Mr. Robert W Wagner, LPC

Individual provider Mental Health Counselor · NPI 1457309387

Mr. Robert W Wagner, LPC is a Mental Health Counselor in Tyrone, Georgia. Qualified in 1996, 30 years ago. Accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
30
Licensed in
GA
In the registry since
2006
Specialties on file
2
What do these letters mean?
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

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Practice location Address checks out

105 Greencastle Rd Ste B
Tyrone, GA 30290-2937
Phone: (770) 486-1011
Show map & directions

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

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 003153 (GA)
Professional Counselor Taxonomy 101YP2500X

Record details

NPI number1457309387
Entity typeIndividual (Type 1)
GenderMale
Credentials LPC
Sole proprietorNo
NPI enumeratedMay 4, 2006
Last updated in NPPESDecember 26, 2007
Mailing address105 Greencastle Rd, Suite B, Tyrone, GA 30290-2937

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 1996 (30 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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