Provider Demographics
NPI:1386676583
Name:MCCAIN, SAVANNA CLOER (PHD)
Entity Type:Individual
Prefix:DR
First Name:SAVANNA
Middle Name:CLOER
Last Name:MCCAIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19903 SANTA ROSA DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72764-9297
Mailing Address - Country:US
Mailing Address - Phone:479-856-6688
Mailing Address - Fax:479-856-6696
Practice Address - Street 1:19903 SANTA ROSA DR
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72764-9297
Practice Address - Country:US
Practice Address - Phone:479-856-6688
Practice Address - Fax:479-856-6696
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR00-11P103T00000X, 103TC1900X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR142830019Medicaid
AR5W287Medicare PIN
AR142830019Medicaid