Provider Demographics
NPI:1255307849
Name:AUGUSTUS, STEVEN W (MA LCPC)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:W
Last Name:AUGUSTUS
Suffix:
Gender:M
Credentials:MA LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 ALANA DR
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-1784
Mailing Address - Country:US
Mailing Address - Phone:815-408-0601
Mailing Address - Fax:815-320-3845
Practice Address - Street 1:320 ALANA DR
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-1784
Practice Address - Country:US
Practice Address - Phone:815-408-0601
Practice Address - Fax:815-320-3845
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-24
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180006665101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional