MEDICARE: DAPHNE ALGAZE LCSW

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	104100000X	Social Worker	218977	MA
2	1041C0700X	Clinical Social Worker	0904010657	VA

General Provider Information

NPI Number	:	1063831238
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAPHNE ALGAZE LCSW

Provider Business Mailing Address
First Line	:	875 RIO EAST CT STE C
Second Line	:
City	:	CHARLOTTESVILLE
State	:	VA
Zip	:	22901-8050
Country	:	US
Telephone Number	:	857-209-4019
Fax Number	:

Provider Business Practice Location Address
First Line	:	875 RIO EAST CT STE C
Second Line	:
City	:	CHARLOTTESVILLE
State	:	VA
Zip	:	22901-8050
Country	:	US
Telephone Number	:	857-209-4019
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/15/2014
Last Update Date	:	01/12/2023

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