Individual provider Active NPI

Gina Marie Damore, LCMHC; LCAS

  • Counselor
  • Cary, NC
National Provider Identifier
1548728694
Registry record updated Apr 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
A13622 Issued in NC
Practice address
515 Keisler Dr Ste 104
Cary, NC 27518-7097
Phone
(949) 231-7595
Fax
(833) 485-4608
NPI assigned
Mar 7, 2019
Last updated
Apr 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X A13622 NC Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCAS-25241 NC

Addresses

Primary practice location

515 Keisler Dr Ste 104
Cary, NC 27518-7097

Mailing address

515 Keisler Dr Ste 104
Cary, NC 27518-7097
Phone (949) 231-7595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A13622NCMDCounselor
LCAS-25241NCMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Centered Living and Wellness, PLLC. Counselor CurrentSince Jan 21, 2024 Accepting new patients
Horizon Integrated Wellness Group, PLLC CurrentSince Jun 16, 2024 Accepting new patients

Locations

120 Towerview Ct
Cary, NC 27513
Phone (919) 585-5085

130 Iowa Ln
Ste 102
Cary, NC 27511
Phone (919) 467-7797

515 Keisler Dr
Ste 104
Cary, NC 27518
Phone (919) 297-8438

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1551916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775001600000",
    "number": "1548728694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 KEISLER DR STE 104",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275187097",
            "telephone_number": "949-231-7595",
            "fax_number": "833-485-4608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 KEISLER DR STE 104",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275187097",
            "telephone_number": "949-231-7595",
            "fax_number": "833-485-4608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMORE",
        "first_name": "GINA",
        "middle_name": "MARIE",
        "credential": "LCMHC; LCAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-07",
        "last_updated": "2026-04-01",
        "certification_date": "2026-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "A13622",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-25241",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.