Provider Demographics
NPI:1306545173
Name:VANCE, SAVANNAH COLLEEN (LPC)
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:COLLEEN
Last Name:VANCE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16119 JACK LONDON CT
Mailing Address - Street 2:
Mailing Address - City:CROSBY
Mailing Address - State:TX
Mailing Address - Zip Code:77532-5523
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8900 EASTLOCH DR
Practice Address - Street 2:BUILDING 300
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-2341
Practice Address - Country:US
Practice Address - Phone:346-314-0022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83807101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional