Provider Demographics
NPI:1457823023
Name:SAVAGE, SAMANTHA (MSW, LMSW)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:SAVAGE
Suffix:
Gender:F
Credentials:MSW, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W WASHINGTON AVE STE 210B
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-2160
Mailing Address - Country:US
Mailing Address - Phone:517-227-6038
Mailing Address - Fax:517-905-6007
Practice Address - Street 1:300 W WASHINGTON AVE STE 210B
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-2160
Practice Address - Country:US
Practice Address - Phone:517-227-6038
Practice Address - Fax:517-905-6007
Is Sole Proprietor?:No
Enumeration Date:2018-12-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801103509104100000X
MI6801115817104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker