Provider Demographics
NPI:1407520398
Name:SUMMERS, SAVANA ROSE (MLADC)
Entity type:Individual
Prefix:
First Name:SAVANA
Middle Name:ROSE
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:MLADC
Other - Prefix:
Other - First Name:SAVANA
Other - Middle Name:ROSE
Other - Last Name:MELANSON BUXTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2 WALL ST STE 200
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101-1518
Mailing Address - Country:US
Mailing Address - Phone:603-668-4111
Mailing Address - Fax:
Practice Address - Street 1:2 WALL ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-1518
Practice Address - Country:US
Practice Address - Phone:603-668-4111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-04
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health