Search › Kentucky › 101YM0800X
Derrick Wagoner, LPCC
NPI 1033529813 · on the registry since 2014
Practice
- Address
- 104 Reynolds Rd
Glasgow, KY 42141 - Phone
- (270) 678-4801
- Fax
- (270) 678-3866
- Organisation at this address
- Alliance Counseling Associates
Alliance Center For Community Empowerment And Support Services, LlcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 26
Additional practice sites
- 1048 Ashley St Ste 201, Bowling Green, KY
- 1600 Scottsville Rd Ste 101, Bowling Green, KY
- 1910 Lyda Ave, Bowling Green, KY
Registry record
- Primary taxonomy
- 101YM0800X
101YM0800X
- Also registered as
- 101YP2500X
- Licence states on file
- KY
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2021-05-12
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Kentucky