Provider Demographics
NPI:1740736560
Name:COREY, SAVANNAH (LCSWA)
Entity Type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:
Last Name:COREY
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 CREEKSIDE WOODS DRIVE
Mailing Address - Street 2:
Mailing Address - City:SWANSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28584
Mailing Address - Country:US
Mailing Address - Phone:910-238-6497
Mailing Address - Fax:910-938-9835
Practice Address - Street 1:20 CREEKSIDE WOODS DRIVE
Practice Address - Street 2:
Practice Address - City:SWANSBORO
Practice Address - State:NC
Practice Address - Zip Code:28584
Practice Address - Country:US
Practice Address - Phone:910-238-6497
Practice Address - Fax:910-938-9835
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0105921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical