Wagner, Matthew

Wagner, Matthew is an sole proprietor health care provider with primary practice located at 545 N Mcdonough St Ste 212 , Decatur GA 30030-3310. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Wagner, Matthew can be contacted via phone (770) 766-8128.

Contact Information

Primary practice address
545 N Mcdonough St Ste 212 Decatur GA 30030-3310
Phone: (770) 766-8128
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X C0212 Georgia
Behavioral Health & Social Service Providers / Professional 101YP2500X 9583 Georgia

Profile Details

NPI number 1053749168
LBN Legal business name Wagner, Matthew
Credentials LPC, CAADC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 29th, 2013
Last updated Nov 1st, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers