Provider Demographics
NPI:1881564078
Name:DUDA, DAMIAN (LMFT)
Entity type:Individual
Prefix:MR
First Name:DAMIAN
Middle Name:
Last Name:DUDA
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 ARROWHEAD AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERHEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11901-6617
Mailing Address - Country:US
Mailing Address - Phone:631-914-0792
Mailing Address - Fax:
Practice Address - Street 1:46 MAIN ST
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11968-4864
Practice Address - Country:US
Practice Address - Phone:631-914-0792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-11
Last Update Date:2025-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002620-01106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist