Healthcare Provider Details

I. General information

NPI: 1255598199
Provider Name (Legal Business Name): MARY LINDA SAVAGE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2008
Last Update Date: 08/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 S ALMA SCHOOL RD LOT 6
MESA AZ
85210-1040
US

IV. Provider business mailing address

535 S ALMA SCHOOL RD LOT 6
MESA AZ
85210-1040
US

V. Phone/Fax

Practice location:
  • Phone: 480-620-1535
  • Fax:
Mailing address:
  • Phone: 480-620-1535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2664
License Number StateAZ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: