Provider Demographics
NPI:1447011580
Name:DAMORE THERAPEUTIC SERVICES
Entity type:Organization
Organization Name:DAMORE THERAPEUTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAMORE
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC, LCASA
Authorized Official - Phone:949-231-7595
Mailing Address - Street 1:125 LOCH BEND LN
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-8407
Mailing Address - Country:US
Mailing Address - Phone:949-231-7595
Mailing Address - Fax:
Practice Address - Street 1:130 IOWA LN STE 102
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-2401
Practice Address - Country:US
Practice Address - Phone:949-231-7595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty