Individual provider Active NPI

Colleen B Fleming-Damon, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Middletown, NY
National Provider Identifier
1174565204
Registry record updated Aug 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
408282 Issued in NY
Practice address
419 E Main St
Middletown, NY 10940-2536
Phone
(845) 342-4774
NPI assigned
Jun 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 408282 NY Primary

Addresses

Primary practice location

419 E Main St
Middletown, NY 10940-2536

Mailing address

111 Maltese Dr
Middletown, NY 10940-2141
Phone (845) 342-4774

Other identifiers 1

IdentifierTypeStateIssuer
408282OtherNYNYS LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040416001395 NY Practitioner - Nurse Practitioner 9133114317 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F303827-1NYMDHospice Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
MJHC Home Care, Inc. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787270400000",
    "number": "1174565204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 MALTESE DR",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402141",
            "telephone_number": "845-342-4774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 E MAIN ST",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402536",
            "telephone_number": "845-342-4774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEMING-DAMON",
        "first_name": "COLLEEN",
        "middle_name": "B",
        "name_prefix": "Ms.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "408282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE",
            "identifier": "408282",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

Verify at the official NPI Registry.