Healthcare Provider Details

I. General information

NPI: 1760226864
Provider Name (Legal Business Name): SAVANNAH DAWN MAKOWSKI LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2024
Last Update Date: 11/21/2024
Certification Date: 11/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4434 COLUMBIA RD STE 205
MARTINEZ GA
30907-4281
US

IV. Provider business mailing address

3405 PEACH ORCHARD RD
AUGUSTA GA
30906-5168
US

V. Phone/Fax

Practice location:
  • Phone: 706-910-0538
  • Fax:
Mailing address:
  • Phone: 706-832-8165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number17014
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberMSW012195
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: