Provider Demographics
NPI:1952915225
Name:HURT, SAVANNAH LYNN (MS)
Entity Type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:LYNN
Last Name:HURT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:SAVANNAH
Other - Middle Name:LYNN
Other - Last Name:POTTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:1 PERIMETER PARK S STE 100N
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35243-3248
Mailing Address - Country:US
Mailing Address - Phone:205-936-2356
Mailing Address - Fax:
Practice Address - Street 1:1 PERIMETER PARK S STE 100N
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35243-3248
Practice Address - Country:US
Practice Address - Phone:205-936-2356
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-03
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4913G104100000X
AL5172C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker