Provider Demographics
NPI:1902814205
Name:SAVAGE, LISA R (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:R
Last Name:SAVAGE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 CHAPMAN RD
Mailing Address - Street 2:STE 100H
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-5490
Mailing Address - Country:US
Mailing Address - Phone:302-292-1334
Mailing Address - Fax:302-292-1349
Practice Address - Street 1:260 CHAPMAN RD
Practice Address - Street 2:STE 100H
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5490
Practice Address - Country:US
Practice Address - Phone:302-292-1334
Practice Address - Fax:302-292-1349
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00002991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical