Provider Demographics
NPI:1053461525
Name:WOODS, SAVANAH (LMSW, ACSW)
Entity Type:Individual
Prefix:MS
First Name:SAVANAH
Middle Name:
Last Name:WOODS
Suffix:
Gender:F
Credentials:LMSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17555 JAMES COUZENS
Mailing Address - Street 2:SUITE 2W
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-2658
Mailing Address - Country:US
Mailing Address - Phone:313-864-2987
Mailing Address - Fax:
Practice Address - Street 1:17555 JAMES COUZENS
Practice Address - Street 2:SUITE 2W
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-2658
Practice Address - Country:US
Practice Address - Phone:313-864-2987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010594551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI273803Medicare UPIN
MI8008913080Medicare UPIN
MIP27230001Medicare ID - Type Unspecified
MI278096Medicare UPIN