Provider Demographics
NPI:1982032330
Name:AGAPE PSYCH SERVICES, PLLC
Entity type:Organization
Organization Name:AGAPE PSYCH SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:WESLEY
Authorized Official - Last Name:MANUEL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:937-329-1298
Mailing Address - Street 1:4800 SPRING LAKE PKWY
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-5593
Mailing Address - Country:US
Mailing Address - Phone:937-329-1298
Mailing Address - Fax:817-394-5075
Practice Address - Street 1:120 W 2ND ST STE 400
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-1602
Practice Address - Country:US
Practice Address - Phone:937-329-1298
Practice Address - Fax:817-394-5075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-23
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TP0814X
TX35136103T00000X
TX34930103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysisGroup - Multi-Specialty