Provider Demographics
NPI:1740968619
Name:SAVAGE, JAMIE (LMSW)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:SAVAGE
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3023 KINGS CANYON LOOP NE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87144-7667
Mailing Address - Country:US
Mailing Address - Phone:505-504-3226
Mailing Address - Fax:
Practice Address - Street 1:3023 KINGS CANYON LOOP NE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87144-7667
Practice Address - Country:US
Practice Address - Phone:505-504-3226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMSWB-2024-0079104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker