Healthcare Provider Details

I. General information

NPI: 1659894186
Provider Name (Legal Business Name): SAVANNAH BAKER LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SAVANNAH GEIGER

II. Dates (important events)

Enumeration Date: 07/17/2017
Last Update Date: 02/13/2024
Certification Date: 02/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3605 W SOUTHERN HILLS BLVD STE 300
ROGERS AR
72758-8265
US

IV. Provider business mailing address

PO DRAWER 2109
RUSSELLVILLE AR
72811
US

V. Phone/Fax

Practice location:
  • Phone: 479-967-2322
  • Fax: 479-967-2876
Mailing address:
  • Phone: 479-967-2322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number11525-M
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: