Keely Louise Wagner, LLP, MS is a
Psychologist based in Clarkston, Michigan. Keely Louise Wagner is licensed to practice in Michigan (license number 6361007929) and her current practice location is
7640 Dixie Hwy Ste 155, Clarkston, Michigan. She can be reached at her office (for appointments etc.) via phone at
(248) 791-9266.
NPI number for Keely Louise Wagner is 1518564657 and her current mailing address is 2790 International Dr Apt 534c, Ypsilanti, Michigan. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1518564657.
Healthcare Provider's Profile
Full Name | Keely Louise Wagner |
---|
Gender | Female |
---|
Speciality | Psychologist |
---|
Location | 7640 Dixie Hwy Ste 155, Clarkston, Michigan |
---|
Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1518564657
- Provider Enumeration Date: 10/01/2020
- Last Update Date: 09/04/2024
Medical Identifiers
Medical identifiers for Keely Louise Wagner such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1518564657 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | 6362009086 (Michigan) | Secondary |
103T00000X | Psychologist | 6361007929 (Michigan) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Keely Louise Wagner is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Keely Louise Wagner, LLP, MS 2790 International Dr Apt 534c, Ypsilanti, MI 48197-8527 Ph: () - | Keely Louise Wagner, LLP, MS 7640 Dixie Hwy Ste 155, Clarkston, MI 48346-2095 Ph: (248) 791-9266 |
Reviews and Comments