Damous L Anderson
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Acworth, GA
NPI 1710875232 · NPPES record last updated Jun 24, 2025
Key facts
- NPI
- 1710875232
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- RN320557 (GA)
- Practice address
- 523 Hardy Dr
Acworth, GA 30102-1168 - Phone
- (404) 783-4609
- NPI assigned
- Jun 24, 2025
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN320557 | GA | MD | Psychiatric/Mental Health Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | RN320557 | GA | Yes |
Addresses
Primary practice location
523 Hardy Dr
Acworth, GA 30102-1168
Mailing address
523 Hardy Dr
Acworth, GA 30102-1168
Phone (404) 783-4609
Other providers in Acworth, GA
- Marianny Giselle Amezquita
- Martin Njifua Amin
- Amna Khan Counseling and Consultation
- Shelley Amos
- Ewa Anaele
- Gregory Anderson
- Katie Anderson
- Lucy Anderson
- Lydia Anderson
- Montana Marie Anderson
All providers in Acworth, GA · Psychiatric/Mental Health Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.