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

Shannon Wagner

Individual provider Professional Counselor · NPI 1790520302

Shannon Wagner is a Professional Counselor in Roscoe, Illinois. Licensed in Illinois. Registered with an NPI since 2024.

Licensed in
IL
In the registry since
2024

Practice location Address checks out

11447 2nd St Ste 9A
Roscoe, IL 61073-9522
Phone: (815) 601-4673
Show map & directions

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

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 178019380 (IL)

Record details

NPI number1790520302
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 26, 2024
Last updated in NPPESJuly 9, 2024
Certification dateJuly 9, 2024
Mailing address515 Pin Oak Rd, Rockton, IL 61072-8023

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