1942963228 NPI number — MS. SAVANNAH LEIGH HELTON LCSW

Table of content: MS. SAVANNAH LEIGH HELTON LCSW (NPI 1942963228)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942963228 NPI number — MS. SAVANNAH LEIGH HELTON LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HELTON
Provider First Name:
SAVANNAH
Provider Middle Name:
LEIGH
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
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:
1942963228
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/18/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
660 S EUCLID AVE
Provider Second Line Business Mailing Address:
CB 8134
Provider Business Mailing Address City Name:
SAINT LOUIS
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63110-1010
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
314-286-1700
Provider Business Mailing Address Fax Number:
314-286-1777

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4444 FOREST PARK AVE
Provider Second Line Business Practice Location Address:
STE 2600
Provider Business Practice Location Address City Name:
SAINT LOUIS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63108-2212
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-286-1700
Provider Business Practice Location Address Fax Number:
314-286-1777
Provider Enumeration Date:
10/14/2021

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:  2019031582 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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