Healthcare Provider Details

I. General information

NPI: 1932066701
Provider Name (Legal Business Name): SAVANNA MATHIAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4224 HOLLAND RD STE 106
VIRGINIA BEACH VA
23452-1900
US

IV. Provider business mailing address

4576 GREENLAW DR
VIRGINIA BEACH VA
23464-6349
US

V. Phone/Fax

Practice location:
  • Phone: 757-933-1636
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904020360
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: