Healthcare Provider Details

I. General information

NPI: 1760314322
Provider Name (Legal Business Name): E.S. CRESCENT COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431 WALKER ST STE 202
AUGUSTA GA
30901-2462
US

IV. Provider business mailing address

1324 LAUREL ST
AUGUSTA GA
30904-5708
US

V. Phone/Fax

Practice location:
  • Phone: 706-691-2921
  • Fax:
Mailing address:
  • Phone: 706-691-2921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: ERYN SAGE CRESCENT
Title or Position: LICENSED PROFESSIONAL COUNSELOR
Credential: LPC
Phone: 706-691-2921