Provider Demographics
NPI:1629011515
Name:SAVAGE, JAMES E JR (PHD)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:E
Last Name:SAVAGE
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7852 16TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-1204
Mailing Address - Country:US
Mailing Address - Phone:202-291-5008
Mailing Address - Fax:202-291-2080
Practice Address - Street 1:7852 16TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-1204
Practice Address - Country:US
Practice Address - Phone:202-291-5008
Practice Address - Fax:202-291-2080
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY571103TC0700X
MDPSY02982103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC023011400Medicaid
MD773211200Medicaid
DC023011400Medicaid