Individual provider Active NPI

Kaliopi Kelly Agas

  • Behavior Technician
  • Clinton Township, MI
National Provider Identifier
1306373907
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
15930 19 Mile Rd Ste 150
Clinton Township, MI 48038-1155
Phone
(586) 464-0175
NPI assigned
May 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

15930 19 Mile Rd Ste 150
Clinton Township, MI 48038-1155

Mailing address

15930 19 Mile Rd Ste 150
Clinton Township, MI 48038-1155
Phone (586) 464-0175

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ellie Sem Clinic, PLLC CurrentSince Dec 6, 2022 Accepting new patients
Macomb Oakland Regional Center Inc. PastSince Jul 24, 2022 Accepting new patients

Locations

15930 19 Mile Rd
Ste 150
Clinton Twp, MI 48038
Phone (586) 281-5866

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1494806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1306373907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15930 19 MILE RD STE 150",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381155",
            "telephone_number": "586-464-0175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15930 19 MILE RD STE 150",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381155",
            "telephone_number": "586-464-0175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGAS",
        "first_name": "KALIOPI",
        "middle_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-15",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.