Provider Demographics
NPI:1811310543
Name:SAVAGE, JULIE (LSW, BSL)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:SAVAGE
Suffix:
Gender:F
Credentials:LSW, BSL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 WHISPER CREEK DR
Mailing Address - Street 2:SUITE 7
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-7770
Mailing Address - Country:US
Mailing Address - Phone:570-522-0304
Mailing Address - Fax:570-522-0475
Practice Address - Street 1:32 WHISPER CREEK DR
Practice Address - Street 2:SUITE 7
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-7770
Practice Address - Country:US
Practice Address - Phone:570-522-0304
Practice Address - Fax:570-522-0475
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-31
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH000972101YM0800X
PASW132200104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PABH000972OtherBSL