1932179058 NPI number — LLOYD PAUL MILTON DAMM LCSW, MSW

Table of content: LLOYD PAUL MILTON DAMM LCSW, MSW (NPI 1932179058)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932179058 NPI number — LLOYD PAUL MILTON DAMM LCSW, MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DAMM
Provider First Name:
LLOYD
Provider Middle Name:
PAUL MILTON
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW, MSW
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932179058
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8275 CEDAR CHASE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FOUNTAIN
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80817-4015
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
719-494-9097
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
DEPARTMENT OF THE ARMY FORT CARSON MEDICAL DEAPARTMENT
Provider Second Line Business Practice Location Address:
ACTIVITY, 1650 COCHRANE CIRCLE
Provider Business Practice Location Address City Name:
FORT CARSON
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80913
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-526-7155
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/23/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  197 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1041C0700X , with the licence number: 6801071538 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)