Provider Demographics
NPI:1336735281
Name:DEISER, SAVANNA ELIZABETH (LCSW)
Entity Type:Individual
Prefix:
First Name:SAVANNA
Middle Name:ELIZABETH
Last Name:DEISER
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 1:3018 ALCAZAR PL APT 305
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-2876
Mailing Address - Country:US
Mailing Address - Phone:561-376-6958
Mailing Address - Fax:
Practice Address - Street 1:12012 S SHORE BLVD STE 108
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-6397
Practice Address - Country:US
Practice Address - Phone:561-424-7175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-15
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL154051041C0700X
FL207131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical