Healthcare Provider Details

I. General information

NPI: 1881580389
Provider Name (Legal Business Name): SAVANNAH ARIEL SHIFFLETT LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2025
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 BRANDYWINE BLVD
TALLEYVILLE DE
19803-1838
US

IV. Provider business mailing address

126 STATURE DR
NEWARK DE
19713-3515
US

V. Phone/Fax

Practice location:
  • Phone: 302-703-7779
  • Fax:
Mailing address:
  • Phone: 302-690-1921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberQ3-0011521
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: