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General NPI Number Information
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NPI Number | 1376881425
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Entity Type | Individual
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Provider Name | KRISTA WAGNER LMHC
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Gender | Female
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Dates
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Enumeration Date | 01/24/2013
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Last Update Date | 02/09/2026
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Provider Practice Location Address
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Address Line | 8550 NE 138TH LN STE 2000-C
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City | THE VILLAGES
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State | FL
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Zip | 32159-8957
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Country | US
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Telephone | 800-457-4573
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Fax | 800-443-6422
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Provider Business Mailing Address
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Address Line | 1485 S SEMORAN BLVD
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City | WINTER PARK
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State | FL
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Zip | 32792-5533
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH13276
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License Number State | FL
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