Keely Louise Wagner, LLP, MS

Psychologist · Clarkston, MI

Individual Active NPI

NPI number 1518564657

Practice location

7640 Dixie Hwy Ste 155
Clarkston, MI 48346-2095
Phone
(248) 791-9266

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NPI record

NPI
1518564657
Entity type
Individual (Type 1)
Enumeration date
October 1, 2020
Last updated
September 4, 2024
Certified
September 4, 2024
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Psychologist Primary 103T00000X 6361007929 MI
Mental Health Counselor 101YM0800X 6362009086 MI

Mailing address

2790 International Dr Apt 534c
Ypsilanti, MI 48197-8527

Other practice locations (1)

  • 315 N Center St, Northville, MI 48167-1277 · (234) 759-7191

About Keely Wagner

Keely Louise Wagner, LLP, MS is a healthcare provider registered in the NPI registry with the primary taxonomy Psychologist (code 103T00000X). The practice location is 7640 Dixie Hwy Ste 155, Clarkston, MI 48346-2095. The NPI number 1518564657 was assigned on October 1, 2020 and the record was last updated on September 4, 2024.

Keely Wagner lists 2 licenses in the registry: #6361007929 (MI) for Psychologist; #6362009086 (MI) for Mental Health Counselor. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Keely Louise Wagner, LLP, MS?

The NPI number is 1518564657.

What is the phone number of Keely Wagner?

The phone number listed for the practice location is (248) 791-9266.

Where is Keely Wagner located?

7640 Dixie Hwy Ste 155, Clarkston, MI 48346-2095.

What is the taxonomy code for Keely Wagner?

The primary taxonomy code is 103T00000X – Psychologist; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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