Provider Demographics
NPI:1790146900
Name:AUGUSTA COUNSELING PROFESSIONALS LLC
Entity Type:Organization
Organization Name:AUGUSTA COUNSELING PROFESSIONALS LLC
Other - Org Name:AUGUSTA COUNSELING PROFESSIONALS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CASSIDY
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:THIGPEN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:706-833-0780
Mailing Address - Street 1:601 N BELAIR SQ STE 3
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-4322
Mailing Address - Country:US
Mailing Address - Phone:706-833-0780
Mailing Address - Fax:844-880-3086
Practice Address - Street 1:601 N BELAIR SQ STE 3
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-4322
Practice Address - Country:US
Practice Address - Phone:706-833-0780
Practice Address - Fax:844-880-3086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-15
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC008833101YP2500X
251S00000X, 261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Single Specialty