Provider Demographics
NPI:1306459235
Name:CALVERT, SAVANNAH ELIZA (MED, EDS, LPC-A)
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:ELIZA
Last Name:CALVERT
Suffix:
Gender:F
Credentials:MED, EDS, LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 RIVERSIDE COTTAGE LN
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:SC
Mailing Address - Zip Code:29670-1253
Mailing Address - Country:US
Mailing Address - Phone:803-873-8672
Mailing Address - Fax:
Practice Address - Street 1:1011 TIGER BLVD STE 610
Practice Address - Street 2:
Practice Address - City:CLEMSON
Practice Address - State:SC
Practice Address - Zip Code:29631-1401
Practice Address - Country:US
Practice Address - Phone:864-633-7937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-29
Last Update Date:2020-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7060101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health