1891926457 NPI number — MS. LINDY JO SAVAGE LICENSED CLINICAL SO

Table of content: MS. LINDY JO SAVAGE LICENSED CLINICAL SO (NPI 1891926457)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891926457 NPI number — MS. LINDY JO SAVAGE LICENSED CLINICAL SO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAVAGE
Provider First Name:
LINDY
Provider Middle Name:
JO
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LICENSED CLINICAL SO
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1891926457
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/30/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
801 WEST MILLS ST.
Provider Second Line Business Mailing Address:
SUITE A
Provider Business Mailing Address City Name:
COLUMBUS
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28922
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-894-2222
Provider Business Mailing Address Fax Number:
828-894-2229

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
801 WEST MILLS ST.
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28922
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-894-2222
Provider Business Practice Location Address Fax Number:
828-894-2229
Provider Enumeration Date:
07/30/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  C000759 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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