Provider Demographics
NPI:1245697317
Name:SAVAGE, DEANNA IRENE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:IRENE
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 1:9426 MILFORD RD
Mailing Address - Street 2:
Mailing Address - City:HOLLY
Mailing Address - State:MI
Mailing Address - Zip Code:48442-9166
Mailing Address - Country:US
Mailing Address - Phone:248-778-5687
Mailing Address - Fax:
Practice Address - Street 1:9426 MILFORD RD
Practice Address - Street 2:
Practice Address - City:HOLLY
Practice Address - State:MI
Practice Address - Zip Code:48442-9166
Practice Address - Country:US
Practice Address - Phone:248-778-5687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-20
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010915241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical