=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790597136
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DAMASCUS COUNSELING SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/22/2025
-----------------------------------------------------
Last Update Date | 01/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4000 CREEKVIEW CIR APT 4320
-----------------------------------------------------
City | CRANBERRY TOWNSHIP
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16066-1149
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-220-4366
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4000 CREEKVIEW CIR APT 4320
-----------------------------------------------------
City | CRANBERRY TOWNSHIP
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16066-1149
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER, COUNSELOR
-----------------------------------------------------
Name | SYDNEY ADAMS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 724-967-4442
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC1900X
-----------------------------------------------------
Taxonomy Name | Counseling Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------