MEDICARE: DR. DAMON A PRYOR

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1699114348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAMON A PRYOR

Provider Business Mailing Address
First Line	:	89 NEEDHAM ST
Second Line	:	APT 2234
City	:	NEWTON HIGHLANDS
State	:	MA
Zip	:	02461-1646
Country	:	US
Telephone Number	:	617-969-0480
Fax Number	:

Provider Business Practice Location Address
First Line	:	935 GREAT PLAIN AVE # 268
Second Line	:
City	:	NEEDHAM
State	:	MA
Zip	:	02492-3031
Country	:	US
Telephone Number	:	508-521-9405
Fax Number	:

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

Provider Enumeration Date	:	06/16/2013
Last Update Date	:	03/26/2025

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