Provider Demographics
NPI:1447837000
Name:MCCANN, DAMON REGINALD (LPC-S, LMFT)
Entity type:Individual
Prefix:MR
First Name:DAMON
Middle Name:REGINALD
Last Name:MCCANN
Suffix:
Gender:M
Credentials:LPC-S, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 EISSMAN RD APT 19
Mailing Address - Street 2:
Mailing Address - City:LEESVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71446-5483
Mailing Address - Country:US
Mailing Address - Phone:985-859-9923
Mailing Address - Fax:
Practice Address - Street 1:411 EISSMAN RD APT 19
Practice Address - Street 2:
Practice Address - City:LEESVILLE
Practice Address - State:LA
Practice Address - Zip Code:71446-5483
Practice Address - Country:US
Practice Address - Phone:985-859-9923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-28
Last Update Date:2021-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA631106H00000X
LA2454101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist