Healthcare Provider Details

I. General information

NPI: 1740968619
Provider Name (Legal Business Name): JAMIE SAVAGE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2023
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3023 KINGS CANYON LOOP NE
RIO RANCHO NM
87144-7667
US

IV. Provider business mailing address

3023 KINGS CANYON LOOP NE
RIO RANCHO NM
87144-7667
US

V. Phone/Fax

Practice location:
  • Phone: 505-504-3226
  • Fax:
Mailing address:
  • Phone: 505-504-3226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWB-2026-0294
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: