Provider Demographics
NPI:1780452292
Name:HARRISON, SAVANNAH SCAFIDE (MS, LPC)
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:SCAFIDE
Last Name:HARRISON
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19565 WALTRIP WAY
Mailing Address - Street 2:
Mailing Address - City:SAUCIER
Mailing Address - State:MS
Mailing Address - Zip Code:39574-5511
Mailing Address - Country:US
Mailing Address - Phone:228-380-0662
Mailing Address - Fax:
Practice Address - Street 1:14231 SEAWAY RD STE 5001
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503-4660
Practice Address - Country:US
Practice Address - Phone:228-206-6863
Practice Address - Fax:228-207-7405
Is Sole Proprietor?:No
Enumeration Date:2023-12-13
Last Update Date:2024-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3047101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health