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NPI Code Detail

MEDICARE: MRS. AMY HELENE DAGEN LCSW

MEDICARE: MRS. AMY HELENE DAGEN 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
1104100000XSocial Worker0904004768VA
2101YM0800XMental Health Counselor0904004768VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3384747OTHERVATRIGON
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124198858
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMY HELENE DAGEN LCSW
Provider Business Mailing Address
First Line : 7447 CENTRAL BUSINESS PARK DR
Second Line :
City : NORFOLK
State : VA
Zip : 23513-2867
Country : US
Telephone Number : 577-565-6007
Fax Number :
Provider Business Practice Location Address
First Line : 7447 CENTRAL BUSINESS PARK DR
Second Line :
City : NORFOLK
State : VA
Zip : 23513-2867
Country : US
Telephone Number : 757-756-5600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2006
Last Update Date : 06/27/2023

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