Organization
CRESCENT CENTER COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JUDY DIANE GABEHART M.ED., LPC (LICENSED PROFESSIONAL COUNSELOR)
(417) 588-5885
Entity
Organization
Contact information
Practice address
104 CRESCENT DR, LEBANON, MO 65536-3301
(417) 588-5885
(417) 588-4296
Mailing address
104 CRESCENT DR, LEBANON, MO 65536-3301
(417) 588-5885
(417) 588-4296
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2000197194
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
494879539
—
MO
Enumeration date
01/11/2010
Last updated
01/11/2010
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