Provider Demographics
NPI:1033458666
Name:THORPE, DAMEKO NAISHON (MSW,LCSWA)
Entity Type:Individual
Prefix:MR
First Name:DAMEKO
Middle Name:NAISHON
Last Name:THORPE
Suffix:
Gender:M
Credentials:MSW,LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11621 RUDOLPH PLACE DR
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28134-9155
Mailing Address - Country:US
Mailing Address - Phone:803-347-6668
Mailing Address - Fax:
Practice Address - Street 1:1977 J N PEASE PL STE 104
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-4528
Practice Address - Country:US
Practice Address - Phone:704-274-2978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-01
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-25384101YA0400X
NCP0078531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical