Healthcare Provider Details

I. General information

NPI: 1063316503
Provider Name (Legal Business Name): DAMIEN DANIEL PERRY PSY.S
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5933 DUNHAM RD
MAPLE HEIGHTS OH
44137-4053
US

IV. Provider business mailing address

5933 DUNHAM RD
MAPLE HEIGHTS OH
44137-4053
US

V. Phone/Fax

Practice location:
  • Phone: 216-438-6010
  • Fax:
Mailing address:
  • Phone: 216-438-6010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberLSP.00549
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: