Provider Demographics
NPI:1043272511
Name:MCKEE, DAPHNE CONNELLY (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAPHNE
Middle Name:CONNELLY
Last Name:MCKEE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-4640
Mailing Address - Country:US
Mailing Address - Phone:919-416-3417
Mailing Address - Fax:
Practice Address - Street 1:2200 W MAIN ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-4640
Practice Address - Country:US
Practice Address - Phone:919-416-3417
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC585103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6000572Medicaid
NC04070OtherBLUE CROSS BLUE SHIELD NC
NC2813130AMedicare ID - Type Unspecified