Healthcare Provider Details

I. General information

NPI: 1588592646
Provider Name (Legal Business Name): DAMARCUS WINN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2838 COLERAIN AVE APT 1
CINCINNATI OH
45225-2299
US

IV. Provider business mailing address

1738 HOLMAN AVE APT 1
COVINGTON KY
41011-2958
US

V. Phone/Fax

Practice location:
  • Phone: 513-259-0864
  • Fax:
Mailing address:
  • Phone: 859-777-6554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: