MEDICARE: MORGAN WAGGONER COUNSELING PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1083562102
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MORGAN WAGGONER COUNSELING PLLC

Provider Business Mailing Address
First Line	:	5608 N ASHLAND AVE APT 3S
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60660-5248
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5608 N ASHLAND AVE APT 3S
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60660-5248
Country	:	US
Telephone Number	:	317-379-3266
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOTHERAPIST
Name	:	MORGAN WAGGONER
Credential	:	LCPC, ATR-P
Telephone Number	:	317-379-3266

Provider Enumeration Date	:	03/17/2026
Last Update Date	:	03/17/2026

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