Healthcare Provider Details

I. General information

NPI: 1578387908
Provider Name (Legal Business Name): SAVANA REUBEN MEISNER MSW, LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2024
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 248
JAMESTOWN CO
80455-0248
US

IV. Provider business mailing address

PO BOX 248
JAMESTOWN CO
80455-0248
US

V. Phone/Fax

Practice location:
  • Phone: 303-817-3805
  • Fax:
Mailing address:
  • Phone: 303-817-3805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLSW.0009922613
License Number StateCO

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: