Provider Demographics
NPI:1164890224
Name:SAVAGE, LASHELLA (MA, CADC, LLPC)
Entity Type:Individual
Prefix:
First Name:LASHELLA
Middle Name:
Last Name:SAVAGE
Suffix:
Gender:F
Credentials:MA, CADC, LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14160 E 14 MILE RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48088-5701
Mailing Address - Country:US
Mailing Address - Phone:313-286-1665
Mailing Address - Fax:
Practice Address - Street 1:14160 E 14 MILE RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48088-5701
Practice Address - Country:US
Practice Address - Phone:313-286-1665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-07
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2-01065101YA0400X
MI6401014603101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)