Provider Demographics
NPI:1275261810
Name:SAVAGE, DANIEL J (MED)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:J
Last Name:SAVAGE
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 BURKE CIR
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:VA
Mailing Address - Zip Code:20158-9544
Mailing Address - Country:US
Mailing Address - Phone:703-554-9170
Mailing Address - Fax:
Practice Address - Street 1:24600 MILLSTREAM DR STE 340
Practice Address - Street 2:
Practice Address - City:STONE RIDGE
Practice Address - State:VA
Practice Address - Zip Code:20105-5686
Practice Address - Country:US
Practice Address - Phone:703-327-0335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704014454101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health