Provider Demographics
NPI:1689786246
Name:LEPAGE-ALSAKKAF, DENISE (LCSW)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:LEPAGE-ALSAKKAF
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 1:1337 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06615-7048
Mailing Address - Country:US
Mailing Address - Phone:203-375-4938
Mailing Address - Fax:
Practice Address - Street 1:21 WATERVILLE RD
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:CT
Practice Address - Zip Code:06001-2097
Practice Address - Country:US
Practice Address - Phone:860-674-2691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005159104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker