MEDICARE: CHRISTY DAMRATH LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	0904009532	VA

General Provider Information

NPI Number	:	1558804922
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTY DAMRATH LCSW

Provider Business Mailing Address
First Line	:	PO BOX 74711
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23236-0012
Country	:	US
Telephone Number	:	804-489-1375
Fax Number	:	804-799-1775

Provider Business Practice Location Address
First Line	:	2807 N PARHAM RD STE 200-54
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23294-4410
Country	:	US
Telephone Number	:	804-489-1375
Fax Number	:	804-799-1775

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/02/2016
Last Update Date	:	04/24/2024

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