Damien A Archambeau, LMT, CLT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

2017-3502 Issued in WV

Practice address

58 Savage CT
Falling Waters, WV 25419-1469

Phone

(301) 842-4606

NPI assigned

Dec 5, 2022

Last updated

Dec 5, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1670198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1730899444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 SAVAGE CT",
            "city": "FALLING WATERS",
            "state": "WV",
            "postal_code": "254191469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 SAVAGE CT",
            "city": "FALLING WATERS",
            "state": "WV",
            "postal_code": "254191469",
            "telephone_number": "301-842-4606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCHAMBEAU",
        "first_name": "DAMIEN",
        "middle_name": "A",
        "credential": "LMT, CLT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-05",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MD",
            "license": "M06141",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "VA",
            "license": "0019016915",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WV",
            "license": "2017-3502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Falling Waters, WV
• Providers in Falling Waters, WV by specialty
• Massage Therapist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; 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.