Provider Demographics
NPI:1043080435
Name:GALLOWAY, SAVANNAH (CDCA)
Entity Type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:
Last Name:GALLOWAY
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23811 CHAGRIN BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5525
Mailing Address - Country:US
Mailing Address - Phone:216-483-1001
Mailing Address - Fax:
Practice Address - Street 1:23811 CHAGRIN BLVD STE 105
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5525
Practice Address - Country:US
Practice Address - Phone:216-483-1001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-05
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH186103101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)