Provider Demographics
NPI:1063831238
Name:ALGAZE, DAPHNE (LCSW)
Entity Type:Individual
Prefix:
First Name:DAPHNE
Middle Name:
Last Name:ALGAZE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 RIO EAST CT STE C
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-8050
Mailing Address - Country:US
Mailing Address - Phone:857-209-4019
Mailing Address - Fax:
Practice Address - Street 1:875 RIO EAST CT STE C
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-8050
Practice Address - Country:US
Practice Address - Phone:857-209-4019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-15
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA218977104100000X
VA09040106571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker