Healthcare Provider Details

I. General information

NPI: 1184344210
Provider Name (Legal Business Name): SAVANNAH MERWIN LCSW, LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2022
Last Update Date: 09/27/2024
Certification Date: 09/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11864 BELLAIRE CIR
THORNTON CO
80233-1751
US

IV. Provider business mailing address

11864 BELLAIRE CIR
THORNTON CO
80233-1751
US

V. Phone/Fax

Practice location:
  • Phone: 720-689-3439
  • Fax: 720-343-4231
Mailing address:
  • Phone: 303-909-5859
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberACD.0002408
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09930530
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: