Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1518564657 Individual Practitioner Female Practitioner

Keely Louise Wagner , LLP, MS

Psychologist • Clarkston, MI

Professional Overview & Biography Verified Profile Summary

Keely Wagner, LLP, MS is a registered healthcare professional specializing in Psychologist in Clarkston, MI. Practice services are available at 7640 DIXIE HWY STE 155 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

7640 Dixie Hwy Ste 155

Clarkston, MI 483462095

Telephone 2487919266
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist in Clarkston, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 35.0 Yrs
State Avg: 26.4 Yrs
Regional Practice Density
27 Specialists

Practicing in Clarkston, MI (2669 Statewide)

Telehealth Adoption Rate
3.7% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-09-04
Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

State License MI 6361007929

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Counselor - Mental Health

NUCC Taxonomy Code: 101YM0800X

State License MI 6362009086

Definition to come...

Secondary Practice Locations

315 N Center St

Northville, MI 481671277

Phone: 2347597191

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

10 Associated Practitioners
Nicole Harty

Counselor - Professional

NPI 1013314061
Lauren Nepjuk

Social Worker - Clinical

NPI 1114701042
Ava Herberger

Social Worker - Clinical

NPI 1124809744
Patrick Marcoux , MS, LPC

Counselor - Mental Health

NPI 1144761172

Master of Science, Licensed Professional Counselor

Tanya Roe , LMSW

Social Worker - Clinical

NPI 1164852430

Licensed Master Social Worker

Olivia-Patricia Nash , MA, LPC

Counselor - Professional

NPI 1215209556

Master of Arts, Licensed Professional Counselor

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location September 04, 2024

Registered at 7640 DIXIE HWY STE 155, CLARKSTON, MI 483462095 (Tel: 2487919266)

👤
Provider Name / Credentials Updated September 04, 2024

Recorded as KEELY WAGNER, LLP, MS

NPI Profile Active October 01, 2020

NPI status registered as active in NPPES database

📍
Updated Practice Location October 01, 2020

Registered at 315 N CENTER ST, NORTHVILLE, MI 481671277 (Tel: 2347597191)

📍
Updated Business Mailing Address October 01, 2020

Registered at 2790 INTERNATIONAL DR APT 534C, YPSILANTI, MI 481978527

👤
Provider Name / Credentials Updated October 01, 2020

Recorded as KEELY WAGNER, TLLP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 01, 2020

Counselor (License #6362009086 in MI)

🟢
Initial NPI Registration & Enumeration October 01, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1518564657
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 01, 2020
Last Update: September 04, 2024
Sole Proprietor: No

Mailing Address

2790 International Dr Apt 534c

Ypsilanti, MI 481978527

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.