Provider Demographics
NPI:1407884042
Name:SAVAGE, PAULA W (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:W
Last Name:SAVAGE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:PAULA
Other - Middle Name:M
Other - Last Name:WEST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:4300 SAPPHIRE CT 110
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-9079
Mailing Address - Country:US
Mailing Address - Phone:252-830-7561
Mailing Address - Fax:252-413-0932
Practice Address - Street 1:231 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-6333
Practice Address - Country:US
Practice Address - Phone:910-353-5354
Practice Address - Fax:910-353-5398
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC004876101YP2500X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6003165Medicaid
NC139A8OtherBCBS
NC2869056AMedicare PIN
NC139A8OtherBCBS