Provider Demographics
NPI:1508020173
Name:AGEE, ARWEN S (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ARWEN
Middle Name:S
Last Name:AGEE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ARWEN
Other - Middle Name:
Other - Last Name:ROTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 VA CTR
Mailing Address - Street 2:116A
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-6719
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 VA CTR
Practice Address - Street 2:116A
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-6719
Practice Address - Country:US
Practice Address - Phone:207-623-8411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-14
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC127151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical