Provider Demographics
NPI:1548728694
Name:D'AMORE, GINA MARIE (LCMHC; LCASA)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:MARIE
Last Name:D'AMORE
Suffix:
Gender:F
Credentials:LCMHC; LCASA
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:
Other - Last Name:DAMORE-PAYNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCMHC; LCASA
Mailing Address - Street 1:120 TOWERVIEW CT
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-3595
Mailing Address - Country:US
Mailing Address - Phone:949-231-7595
Mailing Address - Fax:
Practice Address - Street 1:120 TOWERVIEW CT
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-3595
Practice Address - Country:US
Practice Address - Phone:919-585-5085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-07
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-25241101YA0400X
NCA13622101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)