=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447124383
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SAVANNAH HARRIS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/02/2025
-----------------------------------------------------
Last Update Date | 10/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 67 NORRIS RD
-----------------------------------------------------
City | DUNN
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28334-6477
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-240-4599
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 812 PARTIN RD
-----------------------------------------------------
City | DUNN
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28334-8124
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-703-0623
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | P022601
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------