MEDICARE: SAVANNAH OLIVIA STEWART NCC

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	101YM0800X	Mental Health Counselor		TN

General Provider Information

NPI Number	:	1457214074
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAVANNAH OLIVIA STEWART NCC

Provider Business Mailing Address
First Line	:	7914 GLEASON DR APT 1161
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37919-3929
Country	:	US
Telephone Number	:	865-659-7663
Fax Number	:

Provider Business Practice Location Address
First Line	:	1100 MARION ST STE 102C
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37921-6877
Country	:	US
Telephone Number	:	865-344-6076
Fax Number	:

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

Provider Enumeration Date	:	12/09/2025
Last Update Date	:	12/09/2025

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