Healthcare Provider Details

I. General information

NPI: 1932332095
Provider Name (Legal Business Name): MARGARET WAGNER UNDERWOOD LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2009
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5557 URBANA PIKE # 1109
FREDERICK MD
21704-7277
US

IV. Provider business mailing address

5557 URBANA PIKE # 1109
FREDERICK MD
21704-7277
US

V. Phone/Fax

Practice location:
  • Phone: 240-712-4215
  • Fax:
Mailing address:
  • Phone: 240-712-4215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC5740
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5123
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: