Healthcare Provider Details

I. General information

NPI: 1790151231
Provider Name (Legal Business Name): S.A.V.Y.,L.L.C. (SUCCESS ACHIEVED WHEN VISIONED BY YOU)
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2015
Last Update Date: 11/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5320 SANDWOOD DR
INDIANAPOLIS IN
46235-9782
US

IV. Provider business mailing address

5320 SANDWOOD DR
INDIANAPOLIS IN
46235-9782
US

V. Phone/Fax

Practice location:
  • Phone: 504-289-1067
  • Fax:
Mailing address:
  • Phone: 504-289-1067
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801092790
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number6801092790
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number6801092790
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number6801092790
License Number StateMI

VIII. Authorized Official

Name: VONZOLLA MONIQUE ELLIOTT
Title or Position: OWNER
Credential: LCSW
Phone: 504-289-1067