Provider Demographics
NPI:1114342672
Name:AUGUST, CRYSTAL (LCSW-C)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:
Last Name:AUGUST
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:CRYSTAL
Other - Middle Name:
Other - Last Name:MARCUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4940 HAMPDEN LN
Mailing Address - Street 2:SUITE #210
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-2945
Mailing Address - Country:US
Mailing Address - Phone:301-951-0408
Mailing Address - Fax:301-657-4268
Practice Address - Street 1:4940 HAMPDEN LN
Practice Address - Street 2:SUITE #210
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-2945
Practice Address - Country:US
Practice Address - Phone:301-951-0408
Practice Address - Fax:301-657-4268
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-20
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD32351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical