Provider Demographics
NPI:1649647561
Name:SAVARD, JEDIDIAH SIMEON (PSYD)
Entity type:Individual
Prefix:DR
First Name:JEDIDIAH
Middle Name:SIMEON
Last Name:SAVARD
Suffix:
Gender:
Credentials:PSYD
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 668
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MS
Mailing Address - Zip Code:39060-0668
Mailing Address - Country:US
Mailing Address - Phone:603-520-8107
Mailing Address - Fax:
Practice Address - Street 1:1420 NW GILMAN BLVD
Practice Address - Street 2:STE. 2 #9141
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027
Practice Address - Country:US
Practice Address - Phone:425-243-3665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-26
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC-9675101YM0800X
MSLPC-3198101YM0800X
WALH-60986600101YM0800X
AZLPC-22498101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health