Healthcare Provider Details

I. General information

NPI: 1649887860
Provider Name (Legal Business Name): DAPHNE AGEE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2020
Last Update Date: 07/19/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

62 JUDITH DR
DANBURY CT
06811-3447
US

IV. Provider business mailing address

62 JUDITH DR
DANBURY CT
06811-3447
US

V. Phone/Fax

Practice location:
  • Phone: 631-357-6403
  • Fax:
Mailing address:
  • Phone: 631-357-6403
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number16978
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number103345
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: