Provider Demographics
NPI:1124783451
Name:WATSON, DAMON C (LPC)
Entity type:Individual
Prefix:
First Name:DAMON
Middle Name:C
Last Name:WATSON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:834 NEWARK AVE APT 2R
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-3888
Mailing Address - Country:US
Mailing Address - Phone:646-683-3857
Mailing Address - Fax:
Practice Address - Street 1:834 NEWARK AVE APT 2R
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-3888
Practice Address - Country:US
Practice Address - Phone:646-683-3857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-02
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional