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General NPI Number Information
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NPI Number | 1386135754
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Entity Type | Organization
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Legal Business Name | SAVOY COUNSELING & WELLNESS LLC
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Dates
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Enumeration Date | 05/22/2018
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Last Update Date | 05/22/2018
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Provider Practice Location Address
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Address Line | 1801 WOODFIELD DR UNIT 114
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City | SAVOY
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State | IL
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Zip | 61874-9505
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Country | US
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Telephone | 217-552-7774
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Fax |
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Provider Business Mailing Address
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Address Line | 2507 LYNDHURST DR
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City | CHAMPAIGN
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State | IL
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Zip | 61820-7710
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Country | US
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Telephone | 217-552-7774
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | JAMIE DONSBACH
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Credential | LCSW
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Telephone | 217-552-7774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149011001
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License Number State | IL
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