Provider Demographics
NPI:1720602857
Name:SAVARA, ANDRIA BREMER (LLPC, LLMFT)
Entity Type:Individual
Prefix:
First Name:ANDRIA
Middle Name:BREMER
Last Name:SAVARA
Suffix:
Gender:F
Credentials:LLPC, LLMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6174 MEADOWLARK ST NE
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49341-9221
Mailing Address - Country:US
Mailing Address - Phone:616-308-0257
Mailing Address - Fax:
Practice Address - Street 1:3351 CLAYSTONE ST SE STE G32
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-5794
Practice Address - Country:US
Practice Address - Phone:616-425-2412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-04
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4151000530106H00000X
MI6401018321101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist