Provider Demographics
NPI:1134695851
Name:BURTON, SAVANNAH (LPC-MHSP)
Entity Type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:
Last Name:BURTON
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2255 LANCASHIRE CV
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-4623
Mailing Address - Country:US
Mailing Address - Phone:901-626-8067
Mailing Address - Fax:
Practice Address - Street 1:895 S COOPER ST STE 12&3
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-5604
Practice Address - Country:US
Practice Address - Phone:901-498-9126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-19
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3130101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional