| Doctor Name: | MR. MICHAEL G DAMIAN |
| NPI Number: | 1437344488 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCPC |
| License Number: | 180.005603 |
| Business Practice Address: | 7 S Hospital Dr Murphysboro, IL - 629663333 |
| Business Phone Number: | 6186873418 |
| Business Fax Number: | 6186871859 |
| Mailing Address: | 109 California Street, Po Box 577 CARTERVILLE |
| State: | IL |
| Postal Code: | 629180577 |
| Phone Number: | 6189858221 |
| Fax Number: | 6189854635 |
| NPI Enumeration Date: | 09/12/2007 |
| NPI Last Update Date: | 02/03/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 180.005603 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |