Provider Demographics
NPI:1689273963
Name:DAMIAN WATERS & ASSOCIATES, LLC
Entity Type:Organization
Organization Name:DAMIAN WATERS & ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAMIAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:WATERS
Authorized Official - Suffix:
Authorized Official - Credentials:LCMFT
Authorized Official - Phone:202-744-9430
Mailing Address - Street 1:10000 GREENSPIRE WAY
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2719
Mailing Address - Country:US
Mailing Address - Phone:202-744-9430
Mailing Address - Fax:
Practice Address - Street 1:9701 APOLLO DR STE 491
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-4798
Practice Address - Country:US
Practice Address - Phone:240-547-9565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-19
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)