Jeannette Ann Agnello, MA., L.L.P.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301013681 Issued in MI

Practice address

1424 E 11 Mile Rd
Royal Oak, MI 48067-2026

Phone

(248) 548-4044

Fax

(248) 548-9239

NPI assigned

Oct 2, 2007

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

• Mrs. Keam Agme;;P Professional name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 19, 2014.

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408406400000",
    "number": "1992992093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5776 CELICO LN",
            "city": "DRYDEN",
            "state": "MI",
            "postal_code": "484289201",
            "telephone_number": "586-662-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1424 E 11 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480672026",
            "telephone_number": "248-548-4044",
            "fax_number": "248-548-9239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGNELLO",
        "first_name": "JEANNETTE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "MA., L.L.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-02",
        "last_updated": "2014-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301013681",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301013681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEAM",
            "last_name": "AGME;;P",
            "prefix": "MRS.",
            "credential": "MA., L.L.P.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Shanu Agarwal, MD
• Bonnie Ager
• Devika Aggarwal, MBBS
• Nishant Aggarwal, MD
• Sanjeev Aggarwal, M.D.
• Karen Agresta, OTRL
• Joshua Agrusa, PA
• Colleen Elizabeth Ahern
• Emily Ahern
• Jatin Ahluwalia, DO

• All providers in Royal Oak, MI
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2014; 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.