Provider Demographics
NPI:1316316334
Name:DARMSTADT, JASON (MSN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:DARMSTADT
Suffix:
Gender:M
Credentials:MSN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 W 20TH ST
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44052-3779
Mailing Address - Country:US
Mailing Address - Phone:440-244-3833
Mailing Address - Fax:440-244-5327
Practice Address - Street 1:205 W 20TH ST
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44052-3779
Practice Address - Country:US
Practice Address - Phone:440-244-3833
Practice Address - Fax:440-244-5327
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-21
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH18087363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health