Healthcare Provider Details

I. General information

NPI: 1780503524
Provider Name (Legal Business Name): SARAH ELIZABETH RENE WAGNER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH ELIZABETH RENE PARKER MAIDEN NAME

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 WESTMINSTER DR UNIT 1131
AUSTIN TX
78723-2675
US

IV. Provider business mailing address

5900 WESTMINSTER DR UNIT 1131
AUSTIN TX
78723-2675
US

V. Phone/Fax

Practice location:
  • Phone: 720-289-9895
  • Fax:
Mailing address:
  • Phone: 720-289-9895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number96195
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: