IndividualActive
Scott Wagoner, PHD
NPI 1134738057 · Clinical Child & Adolescent Psychologist · Indianapolis, IN
Provider details
- NPI number
- 1134738057
- Entity type
- Individual
- Primary specialty
- Clinical Child & Adolescent PsychologistBehavioral Health & Social Service Providers
- Credential
- PHD
- Sex
- Male
- Sole proprietor
- No
- License
- 20043486B (IN)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Profile Score
Established profile(68/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
705 Riley Hospital Dr
Indianapolis, IN 46202-5109
Phone: (317) 944-3774
Fax: (317) 944-8521
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 719094
Chicago, IL 60677-9318
Additional practice locations (1)
- 575 Riley Hospital DrIndianapolis, IN 46202-5272Phone: (317) 944-1969
Registry dates
- Enumerated
- 2020-07-27
- Last updated
- 2026-02-07
- Certified
- 2026-02-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.