Provider Demographics
NPI:1700113685
Name:SAVAGE AND COMPANY, INC
Entity type:Organization
Organization Name:SAVAGE AND COMPANY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:STACY
Authorized Official - Middle Name:A
Authorized Official - Last Name:SAVAGE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LMHC, CAP
Authorized Official - Phone:386-503-4388
Mailing Address - Street 1:47 FREEMONT TURN
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-8416
Mailing Address - Country:US
Mailing Address - Phone:386-503-4388
Mailing Address - Fax:386-447-1357
Practice Address - Street 1:21 OLD KINGS RD N
Practice Address - Street 2:SUITE B-208
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-8254
Practice Address - Country:US
Practice Address - Phone:386-503-4388
Practice Address - Fax:386-447-1357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-12
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCAP 4540101YA0400X
FLMH 8612101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty