Provider Demographics
NPI:1407530868
Name:SAVAGE, HARRISON JAMES JR (MAC ,LPC)
Entity Type:Individual
Prefix:MR
First Name:HARRISON
Middle Name:JAMES
Last Name:SAVAGE
Suffix:JR
Gender:M
Credentials:MAC ,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 MONTGOMERY DR
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-2830
Mailing Address - Country:US
Mailing Address - Phone:443-493-0049
Mailing Address - Fax:
Practice Address - Street 1:129 MONTGOMERY DR
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-2830
Practice Address - Country:US
Practice Address - Phone:443-493-0049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-14
Last Update Date:2023-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
GA0168101YA0400X
GALPC013904101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)