Healthcare Provider Details

I. General information

NPI: 1194210963
Provider Name (Legal Business Name): DAMON TREMAYNE SWINEA LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2018
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 LEE PL
FLORIDA NY
10921-1934
US

IV. Provider business mailing address

12 LEE PL
FLORIDA NY
10921-1934
US

V. Phone/Fax

Practice location:
  • Phone: 845-467-3524
  • Fax:
Mailing address:
  • Phone: 845-476-7095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number094626
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06615300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: