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Organization
CRESCENT COUNSELING CENTER
Active
Organization
CRESCENT COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AVERY COLLEEN ALLEN MS, BCBA, LBA (CO-OWNER)
(603) 801-0575
Entity
Organization
Contact information
Practice address
8328 TRAFORD LN STE C, SPRINGFIELD, VA 22152-1667
(603) 801-0575
Mailing address
8328 TRAFORD LN STE C, SPRINGFIELD, VA 22152-1667
(603) 801-0575
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
103K00000X
Behavior Analyst
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
02/19/2021
Last updated
02/23/2021
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