Provider Demographics
NPI:1982817052
Name:SAVAGE, STEPHANIE DIANNE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:DIANNE
Last Name:SAVAGE
Suffix:
Gender:F
Credentials:LCSW
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 69
Mailing Address - Street 2:
Mailing Address - City:CHRISNEY
Mailing Address - State:IN
Mailing Address - Zip Code:47611-0069
Mailing Address - Country:US
Mailing Address - Phone:812-362-7067
Mailing Address - Fax:812-362-7067
Practice Address - Street 1:4333 STATE ROUTE 261
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-2668
Practice Address - Country:US
Practice Address - Phone:812-362-7067
Practice Address - Fax:812-362-7067
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34001268A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical