Provider Demographics
NPI:1043919327
Name:CRESCENT COUNSELING LLC
Entity type:Organization
Organization Name:CRESCENT COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SAVANNAH
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:541-837-6901
Mailing Address - Street 1:1011 SW EMKAY DR STE 207
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-3163
Mailing Address - Country:US
Mailing Address - Phone:541-837-6901
Mailing Address - Fax:
Practice Address - Street 1:1011 SW EMKAY DR STE 207
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3163
Practice Address - Country:US
Practice Address - Phone:541-837-6901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-27
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)