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

Nathanael Wagner

Individual provider Professional Counselor · NPI 1750875704

Nathanael Wagner is a Professional Counselor in Grand Rapids, Michigan. Practices as a sole proprietor. Licensed in Michigan.

Licensed in
MI
In the registry since
2018

Practice location Address checks out

5242 Plainfield Ave NE Ste C
Grand Rapids, MI 49525-1084
Phone: (616) 481-7106
Show map & directions

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

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 6401010643 (MI)

Record details

NPI number1750875704
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJune 21, 2018
Last updated in NPPESJune 21, 2018

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