Provider Demographics
NPI:1285870287
Name:SAVAGE, CHARLOTTE (PSYD)
Entity type:Individual
Prefix:DR
First Name:CHARLOTTE
Middle Name:
Last Name:SAVAGE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41-1347 KALANIANAOLE HWY STE A
Mailing Address - Street 2:
Mailing Address - City:WAIMANALO
Mailing Address - State:HI
Mailing Address - Zip Code:96795-1297
Mailing Address - Country:US
Mailing Address - Phone:808-954-7115
Mailing Address - Fax:808-259-6449
Practice Address - Street 1:41-1295 KALANIANAOLE HWY
Practice Address - Street 2:
Practice Address - City:WAIMANALO
Practice Address - State:HI
Practice Address - Zip Code:96795
Practice Address - Country:US
Practice Address - Phone:808-259-7948
Practice Address - Fax:808-259-6449
Is Sole Proprietor?:No
Enumeration Date:2008-12-21
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X, 103T00000X, 390200000X
HIPSY-1709103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program