Augustine Esezobor, LPC, PHD

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC002158 Issued in GA

Practice address

2777 Jefferson St
Suite 6 & 8
Austell, GA 30168-4054

Phone

(770) 765-5917

Fax

(866) 718-3107

NPI assigned

Feb 27, 2017

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1488153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488153600000",
    "number": "1871033753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2777 JEFFERSON ST",
            "address_2": "SUITE 6 & 8",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301684054",
            "telephone_number": "770-765-5917",
            "fax_number": "866-718-3107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2777 JEFFERSON ST",
            "address_2": "SUITE 6 & 8",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301684054",
            "telephone_number": "770-765-5917",
            "fax_number": "866-718-3107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESEZOBOR",
        "first_name": "AUGUSTINE",
        "credential": "LPC, PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-02-27",
        "last_updated": "2017-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC002158",
            "primary": true
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "GA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Austell, GA
• Providers in Austell, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.