MEDICARE: LENA AGREE JD, PSYD, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1497698153
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LENA AGREE JD, PSYD, LLC

Provider Business Mailing Address
First Line	:	4479 STRATHDALE LN
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48323-2854
Country	:	US
Telephone Number	:	248-219-2548
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 N OLD WOODWARD AVE STE 110
Second Line	:
City	:	BIRMINGHAM
State	:	MI
Zip	:	48009-3884
Country	:	US
Telephone Number	:	248-219-2548
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. LENA AGREE
Credential	:	PSYD
Telephone Number	:	248-219-2548

Provider Enumeration Date	:	04/09/2026
Last Update Date	:	04/09/2026

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