Provider Demographics
NPI:1841612272
Name:DAMATO, ANDREA JOSEPH (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ANDREA
Middle Name:JOSEPH
Last Name:DAMATO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 SPRINGFIELD AVE
Mailing Address - Street 2:SUITE 18 BOX 3
Mailing Address - City:BERKELEY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07922-1286
Mailing Address - Country:US
Mailing Address - Phone:908-403-8957
Mailing Address - Fax:
Practice Address - Street 1:310 SPRINGFIELD AVE
Practice Address - Street 2:SUITE 18 BOX 3
Practice Address - City:BERKELEY HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:07922-1286
Practice Address - Country:US
Practice Address - Phone:908-403-8957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-21
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052398001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical