Provider Demographics
NPI:1902695612
Name:DEBERRY, DAMANY
Entity type:Individual
Prefix:
First Name:DAMANY
Middle Name:
Last Name:DEBERRY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8675 MIDLAND PKWY APT 1T
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-3033
Mailing Address - Country:US
Mailing Address - Phone:347-792-1036
Mailing Address - Fax:
Practice Address - Street 1:370 FOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-4304
Practice Address - Country:US
Practice Address - Phone:347-792-1036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool