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Dr. Leslie Ann Wagner , PhD

Psychologist β€’ Grosse Pointe, MI

Active NPI 1013033398 Individual Practitioner Female Practitioner
Practice location in NPPES

533 Saint Clair St
Grosse Pointe, MI 482301503

Call 3139787792 Location details and other listings
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This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

533 Saint Clair St

Grosse Pointe, MI 482301503

Telephone 3139787792
Fax 3139361084
Organization at the Same NPPES Address or Phone
Barefootsouls-Com Inc Facility NPI 1174835714

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2007

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Grosse Pointe and Michigan

4 active clinicians are listed under Psychologist with a practice address in Grosse Pointe, MI (2,549 in Michigan).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

License # reported to NPPES MI 6301012459

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.

Psychologist - Clinical

NUCC Taxonomy Code: 103TC0700X

License # reported to NPPES MI 6301012459

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Michigan Department of Licensing and Regulatory Affairs.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Other Identifier Nppes
1013033398

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ“
Updated Practice Location May 23, 2019

Registered at 533 SAINT CLAIR ST, GROSSE POINTE, MI 482301503 (Tel: 3139787792)

πŸ“
Updated Business Mailing Address May 23, 2019

Registered at 533 SAINT CLAIR ST, GROSSE POINTE, MI 482301503 (Tel: 3139787792)

πŸ‘€
Provider Name / Credentials Updated May 23, 2019

Recorded as LESLIE WAGNER, PH.D.

βœ…
NPI Profile Active January 28, 2010

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) January 28, 2010

Registered at 26156 VAN DYKE AVE, CENTER LINE, MI 480152110 (Tel: 3139787792)

πŸ“
Business Mailing Address (Initial Record) January 28, 2010

Registered at 26156 VAN DYKE AVE, CENTER LINE, MI 480152110 (Tel: 3139787792)

πŸ‘€
Provider Name / Credentials (Initial Record) January 28, 2010

Recorded as LESLIE KAYE, PH.D.

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) January 28, 2010

Psychologist (license number reported to NPPES: MI 6301012459)

🟒
Initial NPI Registration & Enumeration March 21, 2007

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1013033398
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 21, 2007
Last Update: May 23, 2019
Sole Proprietor: Yes

Mailing Address

533 Saint Clair St

Grosse Pointe, MI 482301503

Phone: 3139787792

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.