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General NPI Number Information
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NPI Number | 1922964089
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Entity Type | Individual
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Provider Name | SAVANNAH ROSE STRAW LPC
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Gender | Female
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Dates
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Enumeration Date | 01/01/2026
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Last Update Date | 01/01/2026
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Provider Practice Location Address
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Address Line | 1137 E 5000N RD
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City | BOURBONNAIS
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State | IL
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Zip | 60914-4229
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Country | US
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Telephone | 815-683-6191
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Fax |
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Provider Business Mailing Address
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Address Line | 640 OLDE OAK DR
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City | BOURBONNAIS
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State | IL
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Zip | 60914-1720
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Country | US
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Telephone | 815-954-7419
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 178022524
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License Number State | IL
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