MEDICARE: AUGUSTA COUNSELING PROFESSIONALS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency
2	261QM1300X	Multi-Specialty Clinic/Center
3	101YP2500X	Professional Counselor	LPC008833	GA

General Provider Information

NPI Number	:	1790146900
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AUGUSTA COUNSELING PROFESSIONALS LLC

Provider Business Mailing Address
First Line	:	601 N BELAIR SQ STE 3
Second Line	:
City	:	EVANS
State	:	GA
Zip	:	30809-4322
Country	:	US
Telephone Number	:	706-833-0780
Fax Number	:	844-880-3086

Provider Business Practice Location Address
First Line	:	2924 PROFESSIONAL PKWY
Second Line	:
City	:	AUGUSTA
State	:	GA
Zip	:	30907-6529
Country	:	US
Telephone Number	:	706-833-0780
Fax Number	:	844-880-3086

Authorized Official
Title or Position	:	LICENSED PROFESSIONAL COUNSELOR
Name	:	MS. CASSIDY NICOLE THIGPEN
Credential	:	LPC
Telephone Number	:	706-833-0780

Provider Enumeration Date	:	03/15/2016
Last Update Date	:	03/19/2025

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