MEDICARE: SAVANNAH SUMMER-WEISS LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker
2	1041C0700X	Clinical Social Worker	CSW.09926139	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336794361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAVANNAH SUMMER-WEISS LCSW

Provider Business Mailing Address
First Line	:	765 MAROONGLEN CT
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-6810
Country	:	US
Telephone Number	:	719-440-2809
Fax Number	:

Provider Business Practice Location Address
First Line	:	441 MANITOU AVE STE 202
Second Line	:
City	:	MANITOU SPRINGS
State	:	CO
Zip	:	80829-2334
Country	:	US
Telephone Number	:	719-440-2809
Fax Number	:	719-440-2809

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/06/2019
Last Update Date	:	03/27/2025

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