Provider Demographics
NPI:1578305892
Name:CRUMPLERS COUNSELING AND CONSULTING SERVICES LLC
Entity type:Organization
Organization Name:CRUMPLERS COUNSELING AND CONSULTING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO & OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:SHONEA
Authorized Official - Last Name:CRUMPLER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:706-432-6268
Mailing Address - Street 1:3114 AUGUSTA TECH DR STE 101
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30906-3372
Mailing Address - Country:US
Mailing Address - Phone:706-432-6268
Mailing Address - Fax:
Practice Address - Street 1:3114 AUGUSTA TECH DR STE 101
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30906-3372
Practice Address - Country:US
Practice Address - Phone:706-432-6268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty