Provider Demographics
NPI:1780226720
Name:WILLIFORD, SAVANNAH (LPCC)
Entity Type:Individual
Prefix:MRS
First Name:SAVANNAH
Middle Name:
Last Name:WILLIFORD
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 145
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40755-0145
Mailing Address - Country:US
Mailing Address - Phone:606-682-8611
Mailing Address - Fax:
Practice Address - Street 1:94 DOGPATCH TRADING CTR
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-8292
Practice Address - Country:US
Practice Address - Phone:606-260-8905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-10
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3747A0650X, 101YM0800X
KY288905101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider