Healthcare Provider Details

I. General information

NPI: 1841663283
Provider Name (Legal Business Name): ANTHONY SAVAGE LGSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2015
Last Update Date: 12/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1155 GRANDVIEW ST
WHEELING WV
26003-3227
US

IV. Provider business mailing address

1155 GRANDVIEW ST
WHEELING WV
26003-3227
US

V. Phone/Fax

Practice location:
  • Phone: 304-218-9127
  • Fax:
Mailing address:
  • Phone: 304-218-9127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberBP00942805
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: