Carol S Agnew, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

4101006139 Issued in MI

Practice address

42627 Garfield Rd Ste 217
Clinton Township, MI 48038-5032

Phone

(248) 210-5018

NPI assigned

Aug 16, 2006

Last updated

Jun 11, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Open Door Counseling Center

  • Clinical Social Worker
  • Clinton Township, MI
  • NPI 1295239416

  Mental Health

  NPD Authorized official

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1497868590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42627 GARFIELD RD STE 217",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480385032",
            "telephone_number": "248-210-5018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42627 GARFIELD RD STE 217",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480385032",
            "telephone_number": "248-210-5018"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "43211 Dalcoma Dr",
            "address_2": "Suite 7",
            "address_purpose": "LOCATION",
            "city": "Clinton Township",
            "state": "MI",
            "postal_code": "480386309",
            "country_code": "US",
            "telephone_number": "586-651-4092",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AGNEW",
        "first_name": "CAROL",
        "middle_name": "S",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "4101006139",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MI",
            "license": "4101006139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12458685",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Clinton Township, MI
• Providers in Clinton Township, MI by specialty
• Marriage & Family Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.