Provider Demographics
NPI:1912690116
Name:HOWARD, SAVANNAH E (LCSW)
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:E
Last Name:HOWARD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SAVANNAH
Other - Middle Name:E
Other - Last Name:BUSHMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:15645 N 35TH AVE APT 345
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85053-7629
Mailing Address - Country:US
Mailing Address - Phone:619-947-8528
Mailing Address - Fax:
Practice Address - Street 1:4801 S LAKESHORE DR STE 204
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7157
Practice Address - Country:US
Practice Address - Phone:480-256-9299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-01
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-22443104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker