Healthcare Provider Details

I. General information

NPI: 1306368261
Provider Name (Legal Business Name): SUZANNE SAVICKAS PHD, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2017
Last Update Date: 05/24/2021
Certification Date: 05/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8577 E MARKET ST
WARREN OH
44484-2345
US

IV. Provider business mailing address

1235 E MAIN ST APT 3
KENT OH
44240-2818
US

V. Phone/Fax

Practice location:
  • Phone: 330-856-6663
  • Fax: 330-856-1581
Mailing address:
  • Phone: 330-931-2740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC.1500570
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: