Basic Information
| Provider Information | |||||||||
| NPI: | 1932179058 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DAMM | ||||||||
| FirstName: | LLOYD | ||||||||
| MiddleName: | PAUL MILTON | ||||||||
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| Credential: | LCSW, MSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8275 CEDAR CHASE DR | ||||||||
| Address2: | |||||||||
| City: | FOUNTAIN | ||||||||
| State: | CO | ||||||||
| PostalCode: | 808174015 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7194949097 | ||||||||
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| Practice Location | |||||||||
| Address1: | DEPARTMENT OF THE ARMY FORT CARSON MEDICAL DEAPARTMENT | ||||||||
| Address2: | ACTIVITY, 1650 COCHRANE CIRCLE | ||||||||
| City: | FORT CARSON | ||||||||
| State: | CO | ||||||||
| PostalCode: | 80913 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7195267155 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/23/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 197 | CO | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | 6801071538 | MI | N | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.