Provider Demographics
NPI:1467131532
Name:AUGUSTUS, COURTENAY TURQUEA GONZALEZ (LPC)
Entity Type:Individual
Prefix:MRS
First Name:COURTENAY
Middle Name:TURQUEA GONZALEZ
Last Name:AUGUSTUS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1970 MAIN ST E STE B25
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-6463
Mailing Address - Country:US
Mailing Address - Phone:770-609-9092
Mailing Address - Fax:
Practice Address - Street 1:1540 VIRGIL MOON RD
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-2548
Practice Address - Country:US
Practice Address - Phone:770-722-8262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-14
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC013934101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional