Provider Demographics
NPI:1821874124
Name:ARMSTEAD, DAMON LEMAR (MFTA)
Entity Type:Individual
Prefix:
First Name:DAMON
Middle Name:LEMAR
Last Name:ARMSTEAD
Suffix:
Gender:M
Credentials:MFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 VILLAGE PLZ STE 218
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40065-1745
Mailing Address - Country:US
Mailing Address - Phone:502-533-0155
Mailing Address - Fax:502-430-3609
Practice Address - Street 1:3044 BRECKENRIDGE LN STE 103
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-2193
Practice Address - Country:US
Practice Address - Phone:502-533-0155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-04
Last Update Date:2023-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY287194106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist