Provider Demographics
NPI:1548801467
Name:AGEE, DESIREE (LSW, LAC)
Entity type:Individual
Prefix:MS
First Name:DESIREE
Middle Name:
Last Name:AGEE
Suffix:
Gender:F
Credentials:LSW, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 CASTLEROCK DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80521-4323
Mailing Address - Country:US
Mailing Address - Phone:918-899-3218
Mailing Address - Fax:
Practice Address - Street 1:2405 MIDPOINT DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-4419
Practice Address - Country:US
Practice Address - Phone:918-899-3218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-02
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLSW.0009924879104100000X
COACD.0002672101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker