Healthcare Provider Details
I. General information
NPI: 1396568416
Provider Name (Legal Business Name): DAMON COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/06/2024
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
521 BRIMFIELD RD
WARREN MA
01083-0108
US
IV. Provider business mailing address
PO BOX 1162
WARREN MA
01083-1162
US
V. Phone/Fax
- Phone: 978-560-3255
- Fax:
- Phone: 978-560-3255
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
CHRISTOPHER
JOHN
DAMON
JR.
Title or Position: MENTAL HEALTH COUNSELOR / OWNER
Credential: LMHC
Phone: 978-560-3255