Provider Demographics
NPI:1922755131
Name:DETTMAN, SAVANNAH (LCHMCA)
Entity Type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:
Last Name:DETTMAN
Suffix:
Gender:F
Credentials:LCHMCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 1/2 EAGLE ST STE E
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-3795
Mailing Address - Country:US
Mailing Address - Phone:828-457-8043
Mailing Address - Fax:828-372-4664
Practice Address - Street 1:13 1/2 EAGLE ST STE E
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-3795
Practice Address - Country:US
Practice Address - Phone:828-457-8043
Practice Address - Fax:828-372-4664
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-08
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA17349101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health