Provider Demographics
NPI:1467425470
Name:BOONE-SAVINSKY, KERRY J (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KERRY
Middle Name:J
Last Name:BOONE-SAVINSKY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3419 VIRGINIA BEACH BLVD # 800
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-4419
Mailing Address - Country:US
Mailing Address - Phone:757-714-1838
Mailing Address - Fax:757-321-6269
Practice Address - Street 1:228 N LYNNHAVEN RD STE 110
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-7514
Practice Address - Country:US
Practice Address - Phone:757-912-6214
Practice Address - Fax:757-321-6269
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-09
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040053051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
278445OtherANTHEM HEALTH KEEPERS
P00129392OtherMCARE RAILROAD
278445OtherANTHEM PPO
327264OtherMANAGED HEALTH NETWORK
2109308OtherMAMSI
VA008952833Medicaid
081722MOtherSENTARA OPTIMA
221420OtherCOM PSYCH
560284OtherMAGELLAN
2109308OtherMAMSI
327264OtherMANAGED HEALTH NETWORK