Provider Demographics
NPI:1558021253
Name:BARNETTE, SAVANNAH G (LMFTA)
Entity Type:Individual
Prefix:MISS
First Name:SAVANNAH
Middle Name:G
Last Name:BARNETTE
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 WATER OAK RD APT 16
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-2455
Mailing Address - Country:US
Mailing Address - Phone:704-778-6790
Mailing Address - Fax:
Practice Address - Street 1:10440 PARK RD STE 300
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-8544
Practice Address - Country:US
Practice Address - Phone:980-237-4766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-21
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12372A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist